Should I get screened for pancreatic cancer?

Type 1 and LADA New to Type 1 Diabetes
#1

I could use a sanity check from some steadier hands than I.

I was diagnosed with LADA about 5 months ago. I’m 31 years old. I am positive for antibodies and am honeymooning on metformin and actos. My sugars are getting to be pretty good, for now. A1C isn’t stable and indicative yet, as I am still settling into my meds. I’ve gone from 215 pounds down to 175 in 3 months and am 5’10. I’ve been stable at 175 for about a month now.

I’m moving due to work, so I’m changing my Endo this month. So I don’t really have a trusted long term doctor. Nor will I for a while. I don’t know who I’ll end up with once I settle, and it takes time to build that kind of trust and familiarity.

Anyhow, my Mother died from Pancreatic Cancer about 6 years ago at the age of 55, which is young for that disease. There really is no history of diabetes or pancreactic cancer in the family before she and I. They felt, at the time, that her pancreatic cancer was a result of radiation therapy that she was administered for Hodgkins disease, many years ago. However, I am having doubts about that explanation now.

Given the known (but only recently noticed) links between diabetes and pancreatic cancer, and my current onset for “unknown reasons,” and my Mother’s case of pancreatic cancer, and my rather fast weight loss, do you all think I should be pushing for screening for pancreatic cancer? If I really want it, I’m going to have to push hard I think. Or am I simply overreacting? This is all rather new to me and I’m having trouble providing my own sanity check.

#2

Hi Bradley,

Understand your concern & you may be overly worried, but screening would put your mind at ease.

If it’s any comfort to you, many people are diagnosed LADA with no family history of diabetes. No one knows the cause of diabetes & rapid weight loss is common, so nothing unusual there. I was diagnosed at 53 with no family history.

Has your doctor determined that you’re insulin resistant? Are you taking insulin in addition to metformin & actos? Insulin protects your beta cells from further burn out.

#3

Thanks Gerri.

I am aware of the growing suggestions that LADA patients move to insulin to protect remaining beta cells. I did push my Endo a bit on the matter. He insisted that the combo of metformin and actos would work in a similar manner to protect further beta destruction, by increasing sensitivity and lowering glucose output. As a result, he said, my beta cells would be doing far less work and be less likely to draw the attention of my immune system. He felt I should be avoiding going on insulin as long as possible due to the risk of going hypo. I’m not sure I totally buy that part, but he seemed to strongly feel that it was worth staying on oral meds if at all possible.

I felt that while this did not match what I had heard on the net, exactly, that it was the same general direction, and was coming from an office of Endos that do nothing but Diabetes all day. So I would stay my interpretation of internet knowledge in favor of the Endo’s judgment, given that he did seem to understand the concept of keeping beta cells alive.

That being said, the fact that I’m moving allows a second opinion. So I intend to bring it up again very soon.

Thanks for your concern and advice.

#4

Well for me the Metformin has reduced my hunger substantially. I have lost 56 pounds since October You dont indicate if you feel less hungry or how your diet is going. I myself am on a very low carb diet.

I recently met with my endo and increased my metformin dosage and am even less hungry and dont have carb cravings. My BG is still in 115 range fasting and my goal is closer to 95.

In my readings many continue to have carb cravings with Metformin and then go on Byetta or simyalin to curb hunger and carb cravings. You could very well be like me and the Metformin is doing the trick for you and has caused this rapid weight loss which is a good thing if you are overweight . Based on your post I would bet your closer to a type 2 as you where heavier for your height.

I would talk to your Dr further to put yourself at ease. For my 2 cents keeping my eye on the ball is the A1C and how controlled your sugars are during the day.

#5

Hi Bradley,

Doctors are justifiably concerned about hypos because low BG, depending on how low, poses an immediate risk, as opposed to high BG that causes a longer term health risk. I wonder if some of this isn’t due more to their concerns with liability rather than our health. It’s also easier to prescribe oral meds than educate patients about using insulin. Endos see more Type 2s. LADA & Type 1s are a much smaller percentage.

If your BG is stable on metformin & actos & you’re not having side-effects, that’s great. If meds aren’t providing good control, high BG & testing positive for antibodies puts beta cells at risk. How are your readings? Type 2s use insulin when meds fail also.

Yay for second opinions.