Creon and diabetes - what to do (2025)

Hi and welcome.

It sounds like you are actually Type 3c (damage to pancreas through disease trauma or surgery) rather than Type 1 (autoimmune attack on the insulin producing beta cells in the pancreas) That might seem a bit pedantic as you should receive treatment as if Type 1, but there are subtle differences with Type 3c which can make it a bit trickier and more "brittle" ie highs and lows can be harder to balance.

Is the nurse who has been helping you a diabetes trained nurse at your GP surgery or a fully qualified Diabetes Specialist Nurse (DSN) who is based at a hospital clinic? That can make all the difference to getting the support you need as a nurse at the GP surgery simply does not have the depth of knowledge to handle complex cases like yours.

Do you have Freestyle Libre sensors or other CGM (Constant Glucose Monitor) opr are you trying to manage with finger prick testing?

Which insulins are you using?

Creon is a digestive enzyme supplement which helps your body to digest food if your pancreas is unable to produce enough. It allows you to get the nutrients from the food you eat, so if you need it and you don't use it, then you will lose weight as well as likely have issues with bowel movement. If you do need it and you don't take it then the food you eat can't be digested, so any carbs that you inject insulin for will not be able to release glucose into the blood stream so you risk having hypos. It may be that your pancreas can still produce some but not enough, so this may be causing swings, but to be honest diabetes is challenging to manage with insulin and no 2 days are the same.
Getting your basal dose(s) right is the main key to better stability, but you have to understand that your basal needs can and do change in response to a number of different factors. Exercise and alcohol being two of the main ones.
For instance I use Levemir as my basal insulin. 22 units in the morning as soon as I wake up usually keeps me reasonably stable during the day most of the time but occasionally I only need 20 but I need anywhere from 0-5 units on a night and that will depend on how much exercise I have done over the past few days. Earlier this week I was needing 3 units at night and sometimes waking up high, but yesterday I did quite a lot of exercise so I didn't take any Levemir last night. I went to bed in the 6s, my levels gently dropped down into the 4s whilst I slept and then rose slightly to 5 when I woke. If I had injected the 3 units the same as the previous night, I would have hypoed quite badly during the night. My levels have run low most of the day today too. Exercise can affect you for up to 48 hours afterwards. Some people find they hypo when they are doing exercise, I tend to hypo when I sleep afterwards. You have to figure out how your body responds and learn to adjust your insulin accordingly. Some people manage to keep their basal the same after exercise but reduce their meal boluses. That doesn't work for me as it is when I sleep that I hypo following exercise.

If you have a CGM and can post a graph of a day when you were having issues, we might be able to make some suggestions. Sometimes it is just a question of timing, particularly if you are getting big meal spikes and you need to inject your insulin a bit further ahead of eating so that the insulin and the glucose hit the blood stream at about the same time. It is all about careful experimtation to see what works for you, so if you currently inject 10 mins before eating and you spike really high, then try injecting 15mins before eating for a few days and if still spiking try 20mins.... and so on until you find the timing that works for you and your insulin. I used to need 45 mins prebolus time at breakfast, but just recently it has reduced a bit. Other meals I just need 15-20 mins, so different times of the day need different timings.

Anyway, I have probably now flooded you with too much info, but if you can show us a graph which demonstrates the problems you are having (if you have CGM) or give us examples of readings if you don't have CGM..... but you really should have it and you may need to be politely pushy to get it, if you don't.