Anand R. Gupte; Chris E. Forsmark


Curr Opin Gastroenterol. 2014;30(5):500-505. 

In This Article

Diabetes in Chronic Pancreatitis

Diabetes due to the destruction of islets in patients with chronic pancreatitis is termed type 3c diabetes.[18] 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.[19] In addition, an absent pancreatic polypeptide response can be used as a specific indicator of type 3c diabetes. Treatment requires PERT[20] 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,[20] the presence of diabetes serves as an additional risk factor in these patients with chronic pancreatitis.