The Enigma of Type 3c Diabetes in Chronic Pancreatitis

Mitnala Sasikala*, Rupjyoti Talukdar, Chivkula Subramanyam and Nageshwar Reddy D

The Enigma of Type 3c Diabetes in Chronic Pancreatitis.

Pancreatogenic or Type 3c diabetes is relatively a new entry in the complex world of diabetes study. While the general population and physicians are well aware of type 1 and type 2 diabetes mellitus, as evidenced by numerous study groups and the reams of guidelines on diagnosis and treatment of type 1 and type 2 diabetes mellitus, relatively much less is
known, considered and documented about diabetes mellitus that occurs secondary to pancreatic diseases.

A casual search of Pubmed reveals less than 100 entries on type 3c diabetes. This may be because physicians earlier considered type 3c diabetes to be of rare occurrence and thus a condition rarely considered in everyday practice. Yet, recent data on
type 3c diabetes showed that it might be more common than generally thought. Studies also propose that this clinically important condition might be consistently under and misdiagnosed in routine clinical practice.

The World Health Organization and American Diabetes Association have categorized diabetes occurring as a result of benign and malignant disease to exocrine pancreas, such as chronic pancreatitis, hemochromatosis, cystic fibrosis, fibrocalculous pancreatopathy, pancreatic trauma, pancreatic cancer and pancreatectomy as Pancreaticogenic diabetes.

It is estimated that about 78.5% of T3cDM patients are with chronic pancreatitis and 8% of T3cDM are suffering from pancreatic cancer. Globally about 10% of the total diabetic population has been diagnosed for Chronic Pancreatitis, which is characterized by progressive fibrosis, irreversible exocrine
and early onset endocrine dysfunction of pancreas. Recurrent and intractable abdominal pain is the dominant clinical hallmark that
mandates aggressive treatment.

Pancreas Open J. 2016; 1(2): 19-21. doi: 10.17140/POJ-1-106