Diabetes Can Be Controlled in Patients After Pancreas Removal

Removing the entire pancreas in patients with cancer or precancerous cysts in part of the organ does not result in unmanageable diabetes — as many physicians previously believed, research at Mayo Clinic in Florida has found. The study, published online Sunday in the journal HPB Surgery, evaluates how well patients who had their entire pancreas removed could control their resulting diabetes. The pancreas produces insulin to remove sugar from the blood, so when the organ is gone, insulin must be replaced, usually through an external pump or with injections.

The researchers examined control of insulin over several years in 14 patients whose entire pancreas was removed. They compared their findings with 100 people with type 1 diabetes, and must use insulin replacement. They found both groups had little difficulty controlling their blood sugar, and no complications resulted.

The findings should reassure physicians and surgeons that removing the entire pancreas is reasonably safe and effective, says senior investigator Michael B. Wallace, M.D., chair of the Division of Gastroenterology & Hepatology at Mayo Clinic in Florida.

"What has confounded surgery for pancreatic cancers and precancerous cysts for a long time is the notion that if the entire organ is removed, patients will have great difficulty in controlling the resulting diabetes," Dr. Wallace says. "Most surgeons try to leave as much of the pancreas as possible".

"What we have shown here is that, due to wonderful recent improvements in insulin therapy, patients without a pancreas can control their blood sugar as effectively as type 1 diabetes patients can," he says.

Diabetes that is not well controlled can lead to many health complications. Diabetes can affect the eyes, heart, nerves and kidneys if blood-sugar levels are not kept in check. Given the seriousness of diabetes, it is always best to speak with a physician about the right treatment plan. Some patients may be able to control diabetes with dietary changes, while others may need medications and/or insulin.

Type 1 Diabetes

After a meal, the body breaks down the food into glucose to be used for energy. The hormone insulin must be present for the cells to use the glucose. If this process is not working correctly, blood-sugar levels can get too high and diabetes can develop. Type 1 diabetes occurs when the body's immune system attacks and destroys the insulin-producing cells of the pancreas. To survive, Type 1 diabetics need multiple insulin injections throughout the day or the use of a pump that continuously injects insulin into the body. However, a healthy diet is still important to fully control blood-sugar levels.

Pre-diabetes

Pre-diabetes, or insulin resistance, is diagnosed when blood-sugar levels are starting to get high but are not high enough to be diagnosed as diabetes. At this stage, a combination of diet and exercise may be all that is needed. The National Diabetes Information Clearinghouse suggests exercising for 30 minutes on most days of the week. Losing just 5 to 7 percent of body weight and eating a diet low in fat and cholesterol may prevent or delay Type 2 diabetes by nearly 60 to 70 percent. It is important to use a combination of diet and exercise. A healthy diet will prevent spikes and fluctuations in blood-sugar levels, and exercise will help the body use insulin more efficiently.