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Undergoing Diabetes Diagnosis
by Bulaone, Sep 19, 2006 12:00AM
I am a 38yr old female (American living in Australia) and have just received a probable diagnosis of diabetes and am currently undergoing tests to determine type 1 or type II. I am an active person, slender and have relatively good eating habits and what I've been told "an atypical case" for diabetes. But I have recently begun losing weight unintentionally. I have quite a healthy appetite and I do have a biological family member who has Type II. I initially asked for the test just as a check whilst undergoing other blood tests for gastro issues. When my fasting level came back elevated, they ordered a glucose tolerance test using 100gms of liquid. Those results have come back elevated and they are now testing c-peptide, cortisol and GAD. I have also asked for another fasting BST just to make sure, as I was extremely stressed and anxious during the other tests.
Since I am an atypical case and I have some current upper abdominal issues, would it be reasonable to request a CT scan to check the pancreas for possible tumors, etc? I had an abdominal ultrasound that had no significant findings, and when I asked my GP about a CT, she doesn't think it necessary as nothing showed up on the ultrasound. I've found a number of articles related to new onset diabetes and the presence of pancreatic cancer. Is this something I should push for? I have had discomfort up under the ribs and am being treated for H. pylori. Advice appreciated.
Since I am an atypical case and I have some current upper abdominal issues, would it be reasonable to request a CT scan to check the pancreas for possible tumors, etc? I had an abdominal ultrasound that had no significant findings, and when I asked my GP about a CT, she doesn't think it necessary as nothing showed up on the ultrasound. I've found a number of articles related to new onset diabetes and the presence of pancreatic cancer. Is this something I should push for? I have had discomfort up under the ribs and am being treated for H. pylori. Advice appreciated.
Doctor's Answer
by JDRF-Team-JW, Sep 19, 2006 12:00AM
Hi Bulaone,
I'm a volunteer here, not a medical professional, and I have been living with Type I diabetes for 12 years. I don't know too much about pancreatic cancer and it's connection to diabetes but I did some research and have found some info on the Amercian Cancer Society's website regarding pancreatic cancer. Here are some excerpts:
Signs and Symptoms of Cancer of the Pancreas
Jaundice: At least half of all people with pancreatic cancer develop jaundice. Jaundice occurs in all cases when the cancer is at the ampulla of Vater. Jaundice is a yellowing of the eyes and skin due to staining by bilirubin (a dark green-colored substance made in the liver). Bilirubin accumulates in these tissues and in the blood.
Pain: Pain in the abdomen or back is a very common sign of advanced cancer of the pancreas. The cancer will often spread to the nerves surrounding the pancreas. This causes some of the pain. It may be constant or may come and go. Of course, many non-cancerous diseases as well as several other types of cancers can also cause abdominal or back pain that can be confused with cancer of the pancreas.
Weight loss: Unintended or unexpected weight loss is very common in patients with cancer of the pancreas. These people also complain of being very tired and having little or no appetite.
Digestive problems: If cancer blocks the release of the pancreatic juice into the intestine, a person may not be able to digest fatty foods. The undigested fat may cause stools to be unusually pale, bulky, greasy, and to float in the toilet. The cancer may also wrap around the far end of the stomach and partly block it. This will cause nausea, vomiting, and pain that tends to be worse after eating.
Gallbladder enlargement: Sometimes the cancer will block the bile duct. This causes bile to accumulate in the gallbladder, which then becomes enlarged. Sometimes the examining doctor can feel this enlargement. It can also be detected by imaging studies.
Blood clots or fatty tissue abnormalities: Sometimes, the first clue that there is a pancreatic cancer is the development of a blood clot in a large vein. These clots can sometimes travel to the lungs and cause trouble with breathing.
Another clue is the development of uneven texture of the fatty tissue underneath the skin. This is caused by the release of the pancreatic enzymes that digest fat.
Diabetes mellitus: Rarely, exocrine cancers of the pancreas cause diabetes mellitus (high blood sugar) because they destroy the insulin-making cells. More often, there are slight problems with sugar metabolism that do not cause symptoms of diabetes but can still be recognized by certain blood tests.
I know you must feel anxious about your symptoms and the diagnosis of diabetes, so if it's possible I'd suggest that you go ahead and do the CT scan -just to put your mind at ease. It's encouraging that your doctor isn't very concern with the possibility of you having pancreatic cancer, but ruling it out completely would make you feel much better. Good luck to you!
I'm a volunteer here, not a medical professional, and I have been living with Type I diabetes for 12 years. I don't know too much about pancreatic cancer and it's connection to diabetes but I did some research and have found some info on the Amercian Cancer Society's website regarding pancreatic cancer. Here are some excerpts:
Signs and Symptoms of Cancer of the Pancreas
Jaundice: At least half of all people with pancreatic cancer develop jaundice. Jaundice occurs in all cases when the cancer is at the ampulla of Vater. Jaundice is a yellowing of the eyes and skin due to staining by bilirubin (a dark green-colored substance made in the liver). Bilirubin accumulates in these tissues and in the blood.
Pain: Pain in the abdomen or back is a very common sign of advanced cancer of the pancreas. The cancer will often spread to the nerves surrounding the pancreas. This causes some of the pain. It may be constant or may come and go. Of course, many non-cancerous diseases as well as several other types of cancers can also cause abdominal or back pain that can be confused with cancer of the pancreas.
Weight loss: Unintended or unexpected weight loss is very common in patients with cancer of the pancreas. These people also complain of being very tired and having little or no appetite.
Digestive problems: If cancer blocks the release of the pancreatic juice into the intestine, a person may not be able to digest fatty foods. The undigested fat may cause stools to be unusually pale, bulky, greasy, and to float in the toilet. The cancer may also wrap around the far end of the stomach and partly block it. This will cause nausea, vomiting, and pain that tends to be worse after eating.
Gallbladder enlargement: Sometimes the cancer will block the bile duct. This causes bile to accumulate in the gallbladder, which then becomes enlarged. Sometimes the examining doctor can feel this enlargement. It can also be detected by imaging studies.
Blood clots or fatty tissue abnormalities: Sometimes, the first clue that there is a pancreatic cancer is the development of a blood clot in a large vein. These clots can sometimes travel to the lungs and cause trouble with breathing.
Another clue is the development of uneven texture of the fatty tissue underneath the skin. This is caused by the release of the pancreatic enzymes that digest fat.
Diabetes mellitus: Rarely, exocrine cancers of the pancreas cause diabetes mellitus (high blood sugar) because they destroy the insulin-making cells. More often, there are slight problems with sugar metabolism that do not cause symptoms of diabetes but can still be recognized by certain blood tests.
I know you must feel anxious about your symptoms and the diagnosis of diabetes, so if it's possible I'd suggest that you go ahead and do the CT scan -just to put your mind at ease. It's encouraging that your doctor isn't very concern with the possibility of you having pancreatic cancer, but ruling it out completely would make you feel much better. Good luck to you!
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Thank you for your time in responding. Yes, it's all very scary indeed and being so far away from home (although I've been away for 7 years now) makes it all the more difficult. If diabetes is the worst of what's going on, I know I accept it, handle it and do my best to control it. Thanks for the well wishes.