Chronic Pancreatitis
Chronic Pancreatitis
Diabetes due to the destruction of islets in patients with chronic pancreatitis is termed type 3c diabetes. This produces a complex diabetic condition, especially in patients with underlying exocrine insufficiency, maldigestion, and malnutrition. Treatment-induced hypoglycemia is common. In a recent consensus report, routine testing of fasting glucose and HbA1c should be performed in patients with chronic pancreatitis. In addition, an absent pancreatic polypeptide response can be used as a specific indicator of type 3c diabetes. Treatment requires PERT to maximize incretin secretion and nutritional status, in addition to diabetic medications, and early referral to an endocrine specialist for this brittle form of diabetes. Although chronic pancreatitis is a risk factor for pancreatic ductal carcinoma, the presence of diabetes serves as an additional risk factor in these patients with chronic pancreatitis.
Diabetes in Chronic Pancreatitis
Diabetes due to the destruction of islets in patients with chronic pancreatitis is termed type 3c diabetes. This produces a complex diabetic condition, especially in patients with underlying exocrine insufficiency, maldigestion, and malnutrition. Treatment-induced hypoglycemia is common. In a recent consensus report, routine testing of fasting glucose and HbA1c should be performed in patients with chronic pancreatitis. In addition, an absent pancreatic polypeptide response can be used as a specific indicator of type 3c diabetes. Treatment requires PERT to maximize incretin secretion and nutritional status, in addition to diabetic medications, and early referral to an endocrine specialist for this brittle form of diabetes. Although chronic pancreatitis is a risk factor for pancreatic ductal carcinoma, the presence of diabetes serves as an additional risk factor in these patients with chronic pancreatitis.
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