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Diabetes after TPIAT Surgery | Cincinnati Children's


TPIAT is an easy way to say Total Pancreatectomy and Islet Auto Transplantation.

This is the name of the surgery to help treat acute recurrent or chronic pancreatitis. But, before we can understand the effects of removing the pancreas, let’s learn about its function in the body.

The pancreas has two systems: the exocrine system and the endocrine system.

The exocrine system in the pancreas produces enzymes, which help our body digest food.

The endocrine system releases hormones directly into our blood to help control the sugar levels inside the body.

The hormones from the endocrine system are made in pancreatic tissue called islet cells, which are found throughout the pancreas. The two hormones released from the islet cells are called insulin and glucagon.

These hormones work together to make sure our bodies have the proper level of sugar in our blood. This blood sugar is what our bodies use for energy!

Insulin is an important hormone and is necessary for survival. Without insulin, our bodies can’t work! Insulin is what allows our body to use the food we eat for energy. This energy from food is the fuel for our body.

Insulin also stores extra energy in the liver in case we need it later. You need insulin to maintain normal body weight and growth. So, as you can see, our bodies really need insulin!

So, if the pancreas and all of its functions are so important, why remove it? This surgery is offered to patients with severe acute recurrent or chronic pancreatitis. The primary goal of the surgery is to alleviate pain, and it has been shown to be very effective in doing so.

When you remove the pancreas, the blood sugar level in the body increases unless you receive insulin.

At Cincinnati Children’s you will have the support of our top-rated insulin therapy program.

We use a continuous glucose monitoring system so you can see what’s happening to your glucose level in real-time!

We also use Insulin Pump therapy in order to be very precise when delivering insulin to you.

These two devices are easy to use. We will train you in how to use them before you go home.

Traditionally, you would check your blood sugar levels using a glucometer. A glucometer is a small machine that requires a small spot of blood to test your blood glucose value.

However, it doesn’t let us know if your blood glucose is on an upward-trend, or on it’s way down.

The Continuous Glucose Monitoring (CGM) system allows you to track these changes in your glucose level over time, removing some of the guesswork around diabetes management. The CGM will monitor your levels and help identify low or high glucose values.

An insulin infusion pump accurately delivers insulin to your body and allows you some flexibility in your eating schedule, even if you get calories via a gastric tube.

A small needle is used to place the pump. The needle is then removed, and a small plastic catheter is left just under the skin. This catheter helps with insulin delivery and needs changed every 2-3 days.

The insulin pump releases the right amount of insulin that your body needs when you are not eating. We call this background or basal insulin.

The pump can also help you calculate the insulin you need to cover the food you eat or correct a high blood glucose. The insulin to cover food and to correct for a high blood glucose value is called bolus insulin.

Who wants to remember all the calculations you need to get the right amount of insulin? The insulin infusion pump delivers your basal insulin automatically and, with a push of a button, delivers your bolus insulin. This system is an alternative to getting insulin injections 4-6 times each day.

Cincinnati Children’s has one of the largest pediatric diabetes care facilities in the United States. We are also consistently ranked as one of the top Endocrinology and Diabetes centers by US News and World Report!

We treat close to 2,000 children with diabetes at any given point in time. We have one of the largest and most experienced diabetes education staff in the US and work hard to make sure that each patient gets the right amount of individual attention.

Cincinnati Children’s has 24/7 phone management run by a team of nurse practitioners, and there is always an over-night physician on-call for emergencies.

Lastly, the Pancreas Care Center at Cincinnati Children’s has created a core team of physicians who place value in communication. The teams work together to meet the needs of all of our patients.

hoosing Cincinnati Children’s for your TPIAT care provides you with access to a comprehensive, highly trained, and experienced team who look forward to caring for you and your family!


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