Two years ago, I had surgery for renal cell and pancreatic cancer, and my left kidney, spleen and 40% of my pancreas (distal tail) were removed. About a year ago a routine blood test revealed slightly elevated sugar levels, and since then, the levels continue to increase so my doctor has suggested a medication to stimulate the pancreas to produce more insulin. but I am afraid that this medication could cause an already damaged pancreas more problems. The diabetes education nurse has suggested an injection of insulin at bedtime to correct the high sugar readings in the morning since my sugar levels are within normal limits at other times of the day.

The development of post-surgery diabetes is a complication of surgery to the pancreas. The majority of the beta cells that make insulin are in the tail of the pancreas so you should be followed closely for the development of diabetes.

When it occurs, the choices for strategies include either decreasing the peripheral insulin resistance or increasing insulin production. Since the pancreas may not be able to increase production, insulin might have to be used. I think the strategy of providing you with a dose of NPH insulin at nighttime sounds perfectly good. This may allow you to start your day with a good blood sugar and let you get by with no medication or only a little during the day. However, a note of caution is in order. Diabetes is an evolving problem. What might be good now may not be good in the future. This means you will have to monitor closely and see how things go.

JTL