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  • Shared Experiences

    How do I look after myself following a pancreatectomy?

    Total pancreatectomy has left me with brittle (unstable) diabetes.
    What is the best way to live with this?
    • Chris Fonda
    • Dr Anubhav Mittal
  • Find a professional to answer your question

  • 1


    Chris Fonda

    Dietitian, Nutritionist, Sports Dietitian

    As an Accredited Sports Dietitian, APD and athlete (springboard diver), Chris has both professional and personal experience in sport at the sub-elite and elite level.Chris ... View Profile

    The pancreas has 2 main functions:

    • Releases digestive enzymes and bicarbonate to enable us to digest food and,
    • Release insulin (and other hormones) which control blood sugar levels

    When you have had your entire pancreas removed, your body can no longer perform the above functions. Mainstay treatment is with pancreatic enzyme replacement therapy (or PERT) to help digest your food, and insulin injections to control blood sugar levels after eating for life

    I would strongly recommend you seek expert advice from your doctor (endocrinologist) and an Accredited Practising Dietitian (APD). An APD is a university trained expert in the field of nutrition and can help you to manage your blood sugar levels and assist with maintaining adequate digestion. To find an APD head to the Dietitian's Association of Australia website (

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    Dr Anubhav Mittal

    Upper GI Surgeon (Abdominal)

    Dr. Mittal specializes in gallbladder, hernia, pancreatic, biliary and liver surgery. He is a specialist hepatobiliary and pancreatic surgeon and a conjoint Senior Lecturer in ... View Profile

    It depends if it is a total pancreatectomy or only part of the pancreas has been removed.

    The pancreas makes insulin (lowers blood sugar), glucagon (raises blood sugar) and pancreatic enzymes that help digest your food (fat, protein, sugars)

    Therefore, if a large part of the pancreas has been removed, you should start on pancreatic enzyme replacement therapy. This is best done by taking 50,000 units of Creon per meal and 25,000 units per snack. This will help you extract all the nutrition from the food.  There is evidence that this helps improve overall survival after pancreatic resection.

    You may also need insulin if a large part of your pancreas has been removed to keep your blood sugar levels in check.  This can be monitored by regular HbA1c testing.

    If all your pancreas has been removed (total pancreatectomy), you will most certainly need insulin and enzyme replacement therapy.


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