Diabetes mellitus secondary to pancreatic diseases (Type 3c) — Are we neglecting an important disease?

Abstract Type 3c diabetes mellitus (T3cDM) is a clinically relevant condition with a prevalence of 5–10% among all diabetic subjects in Western populations. Its prevalence and clinical importance have been underestimated and underappreciated so far. In contrast to the management of type 1 or type 2...

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Bibliographic Details
Published in:European journal of internal medicine 2013-04, Vol.24 (3), p.203-206
Main Authors: Ewald, Nils, Bretzel, Reinhard G
Format: Article
Language:English
Subjects:
Diabetes mellitus
Diabetes Mellitus - diagnosis
Diabetes Mellitus - epidemiology
Diabetes Mellitus - etiology
Diabetes Mellitus - metabolism
Diabetes Mellitus - physiopathology
Diagnostic Errors - prevention & control
Early Diagnosis
Exocrine pancreatic insufficiency
Humans
Incretins - metabolism
Incretins - secretion
Internal Medicine
Malnutrition - etiology
Pancreas, Exocrine - enzymology
Pancreas, Exocrine - pathology
Pancreas, Exocrine - physiopathology
Pancreatic Diseases - complications
Pancreatic Diseases - diagnosis
Pancreatic Diseases - epidemiology
Pancreatic Diseases - metabolism
Pancreatic Diseases - physiopathology
Pancreatitis
Pancreatogenic diabetes
Prevalence
Risk Factors
Type 3 diabetes
Vitamins - metabolism
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Summary:Abstract Type 3c diabetes mellitus (T3cDM) is a clinically relevant condition with a prevalence of 5–10% among all diabetic subjects in Western populations. Its prevalence and clinical importance have been underestimated and underappreciated so far. In contrast to the management of type 1 or type 2 diabetes, the endocrinopathy in T3cDM is very complex and complicated by additional present comorbidities such as maldigestion and concommitant qualitative malnutrition. The failure to correctly diagnose T3cDM leads to failure to implement an appropriate medical therapy of these patients. Physicians should screen for important and easily reversable pathological conditions such as exocrine insufficiency, lack of fat-soluble vitamins (especially vitamin D) and impairment of fat hydrolysis and incretin secretion which are found very commonly in T3cDM. Since most patients with T3cDM suffer from chronic pancreatitis, physicians must additionally be aware of the elevated risk of pancreatic cancer in this subset of patients.
ISSN:0953-6205
1879-0828
DOI:10.1016/j.ejim.2012.12.017