Liver
PROGRAF increased and HIGH A1C
Updated February 6, 2023
in Liver
Hi Bruce, I am on Prograf(30 years, 1993) and have the same memory + language issues for over 3 years now. I was on 2mg in the morning and 1 mg at night, they just increased my dosage to 2mg and 2mg. My A1C SKYROCKED from 5.9 to 8.0. My Dr. wont reduce the Prograft, she wont even respond to me or give me an explanation why, the last thing I want is DIABEATES.
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@BOOBOOCAT Dang, that is really challenging when you don't feel like you're on the same page as your doctor. When I've been in disagreement with my doc about my plan of care, I've sought out a second opinion. Maybe you can ask another doctor's opinion on this matter. Best wishes!
Tx U, I'm done with her, I'm getting a new Dr., just waiting for them to make the appt. U know what her response was "Go see a Endocrinologist" not lets work together and try to figure this out, just wants to pass the buck.
You made a wise choice , I had to switch my PCP too. You have to be able to communicate. I think a lot of PCP are not really on top of caring for TP patients and there meds.
Good Luck with a new PCP
Increased blood sugar or A1C isn't unusual as your liver also contributes to processing sugar in your body as well as your pancreas. Most all of the drugs for Tx increase blood sugar and work against you. Your A1C isn't always the most accurate test for blood sugar. The A1C test is a commonly used indicator of average blood sugar levels over the past 2-3 months. However, it is not necessarily the best indicator for every individual, as factors such as blood glucose fluctuations, hemoglobin variants, and conditions like anemia can affect A1C results. A fructosamine may be a better indicator. The Fructosamine test is a blood test that measures the average level of glucose in the blood over the past 1-3 weeks. Unlike the A1C test, which measures average blood sugar over the past 2-3 months, the Fructosamine test provides a more short-term measurement of glucose control. The test measures the amount of glucose that has bonded to a protein called fructosamine, which is produced when glucose binds to proteins in the blood. Fructosamine levels are influenced by recent changes in blood glucose levels, and can be used to monitor glucose control in conditions where the A1C test is not appropriate, such as in individuals with rapidly changing glucose levels or conditions affecting red blood cell lifespan. Yeah, you need a new Dr. Most PCPs do not have enough training in caring for Tx patients. They are hard to find. You don't want a Dr. that BSs their way in caring for patients. At the same time, you don't want a doc that is scared to deal with you. I have a pretty good PCP, but he has made some wrong decisions. A good RN, NP, or PA, that work or have worked in a Tx center are often more knowledgeable than MDs. Some of the best Dr.s I have ran across were in ERs or urgent care centers. I am diabetic and it came with the Tplant. I manage with insulin injections. Diet and exercise are VERY important in keeping your blood sugar inline. I can drop my blood sugar 100 pts. with a brisk 1/2 mi. walk. Also, you might want to get a CGM (constant glucose monitor) to keep track of your blood sugar. You'll need an Rx from your Dr. Medicare will help to cover it and many insurances. Online is the best and cheapest way to go. Good luck!
Also, stay away from some of the newer Type II medications such as Ozempic...too many cases of adverse reactions that are life threatening.
Sorry, I am wordy today, but I will pass this on: Many liver transplant patients develop diabetes after transplantation due to a condition called "secondary diabetes." This occurs because the liver is responsible for producing glucose and regulating glucose levels in the body. When a person has liver disease, their liver may not be able to regulate glucose properly, leading to high glucose levels and eventually, diabetes. After a liver transplant, the new liver may not function as well as the original liver, leading to glucose regulation problems and development of diabetes. Additionally, some of the medications used to prevent rejection of the transplanted liver, known as immunosuppressive medications, can also impair glucose regulation and increase the risk of developing diabetes. These medications can affect the way insulin works, leading to high glucose levels and insulin resistance.
Hi A.Ray, Thank u for sharing this with us. There are so many medical conditions that I was not aware that TP patients can have problems with. I had sugar problems right after my LTP and had to be on insulin for a little while no longer have to now. I have more kidney concerns now due to Tacro. I am an active walker and try to watch my diet, drink water. It is frustrating for sure but u have to live life and enjoy each and every day💚😊
Thanks again for your information.🦋🌼🌸
Wow thanks for all the info.
Tx U
Transplant Patient
@Bobzillaaz - at this point, you should definately go see a specialist (endocrinologist). A lot of PCP(primary care physicians) like to think they can address all issues with their patients - but, often that's not the case.
Being a diabetic (pre & post transplant) - I'm very particular about seeing specialists.
Best of luck to you & congratulations on being blessed with your Gift of Life for 30 years!! Inspirational & remarkable indeed!
Thank U so much