Colon Cancer and Low Blood Sugar

[lawmama]

This is my first topic/posting ont this website. My father was diagnosed with Stage IV colon cancer and "innumerable" liver mets Dec. 23, 2009. He had colon resection surgery Jan. 8 and will have a port put in tomorrow. Next Monday, he starts FOLFOX4 and Avastin. He is diabetic which leads me to this question:

Since his surgery, his blood sugar has been abnormally low. My mom tells me that he wakes up around 5am or so feeling very exhausted and dizzy. His blood sugar will be between 45-65. He's not taking any medications for his diabetes right now. His doctor hasn't offered any help on this issue and says it's from the liver mets.

Has anyone experienced very low blood sugar with colon cancer/liver mets? Any advice?

Don't get me wrong, he's enjoying being able to eat whatever he wants (and he's eating a lot of desserts to raise his blood sugar). But it's scary when it gets this low.

Thanks,
Wafa

[jscho]

Since he is not taking insulin or other medications, I don't see what can be done, other than to eat more carbs before going to bed. I suppose the doctor is suggesting that the gluconeogenesis that normally occurs in the liver is compromised, so that the blood glucose levels can not be buoyed up after the cancer cells deplete it.

I haven't heard of this kind of problem leading to diabetic shock, but it might be a good idea to get some glucagon from your favorite pharmacy to use in the event of an emergency.

Good luck,
Jeremy

[CRguy]

He's not taking any medications for his diabetes right now. His doctor hasn't offered any help on this issue and says it's from the liver mets.....Any advice?

You may want to consider an Internal medicine/endocrine consult as well ??? Sounds like a "Dr. House" kind of case ?? there could be a paraneoplastic syndrome or a more direct relationship to the actual liver mets...but if his doc doesn't offer any help...then keep looking for an answer with someone who wants to "know", would be my advice.

.... he's eating a lot of desserts to raise his blood sugar). But it's scary when it gets this low.
Thanks, Wafa

If he's a Type 1 diabetic he would have had the "low blood sugar" emergency talk with his doc ?? IF not, have it now. With underlying metabolic disease like Type 1 DM, AND Stage IV cancer...his whole body's metabolism is nowhere close to being normal. Scarfing down extra carbohydrates and sweets would not be my first choice, without having an actual picture of what his blood glucose and insulin levels are actually doing over a 24 hour period. Insulin and glucagon are significant, but there are a huge number of factors which influence "blood glucose" levels in people with NO cancer or diabetes.

You did ask for advice, so mine would be : dig deeper into his situation and get all the answers ???

Hope things go well for you / him
Cheers
CRguy

[lawmama]

Thanks, guys! I have searched high and low online but couldn't find anything definitive on this issue so I was hoping someone else has had a similar problem. I think we may just have to consult another doc (internist, maybe). Thanks anyway!