questions, questions, questions re: diabetes caused by medication

[nuked]

I have type 2 diabetes due to a anti-rejection medication that I have to take (had a transplant to treat bone marrow leukemia 6yrs ago).  The medication is prograf/traclerimous/FK506 (it has 3 names to refer to).  For the past 3-4 mos my endo doc has gradually been increasing the insulin she placed me on.  MY QUESTIONs: HOW can you control diabetes when it is caused by a medication and you are still taking the medication?  2.) HOW does prograf give you diabetes? I'm assuming it is the effect it has on the islets of the pancreas, but I'm not sure.  Last month my dr said I was insulin insufficient; this week she changed it to insulin resistant.  Can anyone answer my questions? or add info?  thanks.

[JDRF-Team-LRS]

Hello nuked,
We are volunteers here with lots of experience with Type 1 diabetes (an autoimmune disease) so I recommend that you also work with an endocrinologist or diabetes specialist to help you work through your questions and treatments.

I am generally familiar with Type 2 -- most often associated with being overweight and the more overweight a person is, the insulin-resistant (IR) they can be.  As I understand it, IR is a syndrome where a person's body is pumping out plenty of insulin in response to food, but the insulin isn't being taken up well enough by the cells that need it.  When folks get closer to a healthy weight, IR subsides.  It is believed that somehow the fat impedes the body's sensitivity to insulin.

Insulin insufficiency results when the body cannot produce enough insulin to meet the needs.  The insulin-producing cells may have been exhausted by producing a lot (due to IR) or may simply be fatiguing ...

For Type 2 it is important to know which issue is causing the elevated blood sugar, because there are different medication choices depending on whether IR or insufficiency is an issue. And yes, some folks have both issues, so they'll need insulin supplementation and oral meds to enable their bodies to use the extra insulin.

I have no formal medical training, so be sure to review these ideas with someone specializing in diabetes. I would think they've worked with quite a few patients dealing with medication-induced diabetes.  Good luck with all this; I hope your leukemia remains a thing of the past, too.