Friday, March 19, 2010

Pancreatitis and Type 1 Diabetes

This post was edited significantly after I discussed the facts with my doctor.

On Wednesday I was discharged from the hospital. The diagnoses I accrued while there were: choledocholithiases, cholangitis, and the biggee, gallstone pancreatitis. The spell checker thinks all of those are misspellings. Sorry, spell checker.
I had asked to be tested for pancreatitis three times in the past year, and had been. In fact, only ten days before my hospital admission, my lipase was 11; at admission it was 4040.

An ultrasound showed three stones in my pancreas, and an endoscopic retrograde cholangiopancreatography was performed, removing, according to my discharge papers "2 large stones and several stone fragments".

In type 1 diabetes, the production of amylase and lipase is often mildly to moderately abnormal and may not be an accurate marker of pancreatitis. BEWARE.

Anyways, I am on the mend. I am dealing with much lower insulin needs, probably 'cause I'm not in so much pain and am eating less. Last night I took only 7 units of Lantus, but woke up with a blood sugar of 39 this morning. I think tonight I will take 5.5 units of Lantus instead.

Sunday, March 07, 2010

Tough News

I got my bloodwork results back on Tuesday, and I've been in shock since then.
My A1c was 7.0%, which was higher than I was hoping for but not a huge big deal.
My vitamin D levels were very low, and I have started on a repletion dose of 8000 IU per day, dissolved in olive oil.
My hemoglobin and hematocrit were moderately and mildly elevated, and I'm hoping that that was caused by dehydration.

But the kick in the stomach was that my liver enzymes, the ALT and the AST, came back dramatically elevated. I went in for more bloodwork on Friday and should have results on Monday. I will also be going in for an abdominal ultrasound this week. If the liver enzymes are high again, and the extra bloodwork and the ultrasound do not reveal an obvious cause, then I'll be seeing a gastroenterologist or hepatologist.
I am taking a low dose of testosterone, and my endo had hoped that this could be the cause, but he doesn't think it's likely; neither does the doctor who prescribes my T. Friday's bloodwork included a check of testosterone levels.

I believe that at this point the most likely diagnosis is autoimmune hepatitis, and I am scared.

I intend to post February diabetes stats soon, but right now they seem sort of moot point.