Type 3c diabetes

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Type 3c diabetes

Type 3c diabetes (also known as pancreatogenic diabetes) is diabetes that comes secondary to pancreatic diseases, [1] involving the exocrine and digestive functions of the pancreas. It also occurs following surgical removal of the pancreas.

Contents

Around 5–10% of cases of diabetes in the Western world are related to pancreatic diseases. Chronic pancreatitis is most often the cause. [1] [2]

Presentation

The symptoms of Type 3c diabetes are the same as other forms of diabetes. They include:[ citation needed ]

People with Type 3c diabetes typically also have symptoms of exocrine pancreatic insufficiency, which include:[ citation needed ]

It is important to see a healthcare provider if you have these symptoms.

The same complications that occur for other types of diabetics (type 1 and type 2) may occur for type 3c diabetics. These include retinopathy, nephropathy, neuropathy, and cardiovascular disease. Patients with this condition are advised to follow the same risk-reduction guidelines as the other diabetics do and keep blood sugars as normal as possible to minimize any complications.[ citation needed ]

Cause

There are multiple causes. Some of which identified are:

Diagnosis

Diagnostic Criteria for T3cDM
Major criteria (all must be fulfilled):
  • Presence of exocrine pancreatic insufficiency (according to monoclonal fecal elastase-1 or direct function tests).
  • Pathological pancreatic imaging: (by endoscopic ultrasound, MRI, or CT)
  • Absence of T1DM-associated autoimmune markers (autoantibodies).
Minor Criteria:
  • Impaired β-cell function
  • No excessive insulin resistance (e.g. as measured by HOMA-IR).
  • Impaired incretin (e.g. GIP) or pancreatic polypeptide secretion.
  • Low serum levels of lipid (fat) soluble vitamins (A, D, E, or K).

Management

The condition can be managed by many factors.[ citation needed ]

Lifestyle Modifications

Avoiding toxins to the body such as alcohol and smoking reduce pancreatic inflammation. Also, eating a diet rich in fiber and consuming normal amounts of fat may help. Oral pancreatic enzymes may be given. Maintaining sufficient levels of vitamin D can also reduce symptoms and help manage the disease better.[ citation needed ]

Medications

Medications such as insulin may be given in order to lower blood sugars. For not so high blood sugars, oral treatments in the form of a pill or capsule may be given.

Usually, insulin requirements are lower than in type 1 diabetes (SAID). [7] However, therapeutic challenges may arise from the fact that hypoglycaemia is a common complication, owing to the lack of alpha cells. [7]

See also

Related Research Articles

<span class="mw-page-title-main">Pancreas</span> Organ of the digestive system and endocrine system of vertebrates

The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e., it has both an endocrine and a digestive exocrine function. 99% of the pancreas is exocrine and 1% is endocrine. As an endocrine gland, it functions mostly to regulate blood sugar levels, secreting the hormones insulin, glucagon, somatostatin and pancreatic polypeptide. As a part of the digestive system, it functions as an exocrine gland secreting pancreatic juice into the duodenum through the pancreatic duct. This juice contains bicarbonate, which neutralizes acid entering the duodenum from the stomach; and digestive enzymes, which break down carbohydrates, proteins and fats in food entering the duodenum from the stomach.

The following is a glossary of diabetes which explains terms connected with diabetes.

<span class="mw-page-title-main">Pancreatitis</span> Inflammation of the pancreas

Pancreatitis is a condition characterized by inflammation of the pancreas. The pancreas is a large organ behind the stomach that produces digestive enzymes and a number of hormones. There are two main types: acute pancreatitis, and chronic pancreatitis.

<span class="mw-page-title-main">Pancreas transplantation</span>

A pancreas transplant is an organ transplant that involves implanting a healthy pancreas into a person who usually has diabetes.

<span class="mw-page-title-main">Pancreatic cancer</span> Type of endocrine gland cancer

Pancreatic cancer arises when cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a mass. These cancerous cells have the ability to invade other parts of the body. A number of types of pancreatic cancer are known.

Maturity-onset diabetes of the young (MODY) refers to any of several hereditary forms of diabetes mellitus caused by mutations in an autosomal dominant gene disrupting insulin production. Along with neonatal diabetes, MODY is a form of the conditions known as monogenic diabetes. While the more common types of diabetes involve more complex combinations of causes involving multiple genes and environmental factors, each forms of MODY are caused by changes to a single gene (monogenic). GCK-MODY and HNF1A-MODY are the most common forms.

<span class="mw-page-title-main">Acute pancreatitis</span> Medical condition

Acute pancreatitis (AP) is a sudden inflammation of the pancreas. Causes, in order of frequency, include: a gallstone impacted in the common bile duct beyond the point where the pancreatic duct joins it; heavy alcohol use; systemic disease; trauma; and, in children, mumps. Acute pancreatitis may be a single event; it may be recurrent; or it may progress to chronic pancreatitis.

<span class="mw-page-title-main">Chronic pancreatitis</span> Medical condition

Chronic pancreatitis is a long-standing inflammation of the pancreas that alters the organ's normal structure and functions. It can present as episodes of acute inflammation in a previously injured pancreas, or as chronic damage with persistent pain or malabsorption. It is a disease process characterized by irreversible damage to the pancreas as distinct from reversible changes in acute pancreatitis. Tobacco smoke and alcohol misuse are two of the most frequently implicated causes, and the two risk factors are thought to have a synergistic effect with regards to the development of chronic pancreatitis. Chronic pancreatitis is a risk factor for the development of pancreatic cancer.

<span class="mw-page-title-main">Gastrointestinal disease</span> Medical condition

Gastrointestinal diseases refer to diseases involving the gastrointestinal tract, namely the esophagus, stomach, small intestine, large intestine and rectum, and the accessory organs of digestion, the liver, gallbladder, and pancreas.

<span class="mw-page-title-main">Pancreatic enzymes (medication)</span> Amylase, lipase, and protease mixture

Pancreatic enzymes, also known as pancreases or pancrelipase and pancreatin, are commercial mixtures of amylase, lipase, protease and lactase. They are used to treat malabsorption syndrome due to certain pancreatic problems. These pancreatic problems may be due to cystic fibrosis, surgical removal of the pancreas, long term pancreatitis, pancreatic cancer, or MODY 5, among others. The preparation is taken by mouth.

<span class="mw-page-title-main">Pancreatectomy</span> Surgical removal of the pancreas

In medicine, a pancreatectomy is the surgical removal of all or part of the pancreas. Several types of pancreatectomy exist, including pancreaticoduodenectomy, distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy. In recent years, the TP-IAT has also gained respectable traction within the medical community. These procedures are used in the management of several conditions involving the pancreas, such as benign pancreatic tumors, pancreatic cancer, and pancreatitis.

<span class="mw-page-title-main">Exocrine pancreatic insufficiency</span> Human disease

Exocrine pancreatic insufficiency (EPI) is the inability to properly digest food due to a lack or reduction of digestive enzymes made by the pancreas. EPI can occur in humans and is prevalent in many conditions such as cystic fibrosis, Shwachman–Diamond syndrome, different types of pancreatitis, multiple types of diabetes mellitus, advanced renal disease, older adults, celiac disease, IBS-D, IBD, HIV, alcohol-related liver disease, Sjogren syndrome, tobacco use, and use of somatostatin analogues.

Pancreatic diseases are diseases that affect the pancreas, an organ in most vertebrates and in humans and other mammals located in the abdomen. The pancreas plays a role in the digestive and endocrine system, producing enzymes which aid the digestion process and the hormone insulin, which regulates blood sugar levels. The most common pancreatic disease is pancreatitis, an inflammation of the pancreas which could come in acute or chronic form. Other pancreatic diseases include diabetes mellitus, exocrine pancreatic insufficiency, cystic fibrosis, pseudocysts, cysts, congenital malformations, tumors including pancreatic cancer, and hemosuccus pancreaticus.

<span class="mw-page-title-main">Vildagliptin</span> Chemical compound

Vildagliptin, sold under the brand name Galvus and others, is an oral anti-hyperglycemic agent of the dipeptidyl peptidase-4 (DPP-4) inhibitor class of drugs. Vildagliptin inhibits the inactivation of GLP-1 and GIP by DPP-4, allowing GLP-1 and GIP to potentiate the secretion of insulin in the beta cells and suppress glucagon release by the alpha cells of the islets of Langerhans in the pancreas.

<span class="mw-page-title-main">Hereditary pancreatitis</span> Medical condition

Hereditary pancreatitis (HP) is an inflammation of the pancreas due to genetic causes. It was first described in 1952 by Comfort and Steinberg but it was not until 1996 that Whitcomb et al isolated the first responsible mutation in the trypsinogen gene (PRSS1) on the long arm of chromosome seven (7q35).

Pancreatic elastase is a form of elastase that is produced in the acinar cells of the pancreas, initially produced as an inactive zymogen and later activated in the duodenum by trypsin. Elastases form a subfamily of serine proteases, characterized by a distinctive structure consisting of two beta barrel domains converging at the active site that hydrolyze amides and esters amongst many proteins in addition to elastin, a type of connective tissue that holds organs together. Pancreatic elastase 1 is a serine endopeptidase, a specific type of protease that has the amino acid serine at its active site. Although the recommended name is pancreatic elastase, it can also be referred to as elastase-1, pancreatopeptidase, PE, or serine elastase.

<span class="mw-page-title-main">Insulitis</span> Medical condition

Insulitis is an inflammation of the islets of Langerhans, a collection of endocrine tissue located in the pancreas that helps regulate glucose levels, and is classified by specific targeting of immune cell infiltration in the islets of Langerhans. This immune cell infiltration can result in the destruction of insulin-producing beta cells of the islets, which plays a major role in the pathogenesis, the disease development, of type 1 and type 2 diabetes. Insulitis is present in 19% of individuals with type 1 diabetes and 28% of individuals with type 2 diabetes. It is known that genetic and environmental factors contribute to insulitis initiation, however, the exact process that causes it is unknown. Insulitis is often studied using the non-obese diabetic (NOD) mouse model of type 1 diabetes. The chemokine family of proteins may play a key role in promoting leukocytic infiltration into the pancreas prior to pancreatic beta-cell destruction.

<span class="mw-page-title-main">Renal cysts and diabetes syndrome</span> Medical condition

Renal cysts and diabetes syndrome (RCAD), also known as MODY 5 or HNF1B-MODY, is a form of maturity onset diabetes of the young.

<span class="mw-page-title-main">Canine pancreatitis</span>

Canine pancreatitis is inflammation of the pancreas that can occur in two very different forms. Acute pancreatitis is sudden, while chronic pancreatitis is characterized by recurring or persistent form of pancreatic inflammation. Cases of both can be considered mild or severe.

Cystic fibrosis–related diabetes (CFRD) is diabetes specifically caused by cystic fibrosis, a genetic condition. Cystic fibrosis related diabetes mellitus (CFRD) develops with age, and the median age at diagnosis is 21 years. It is an example of type 3c diabetes – diabetes that is caused by damage to the pancreas from another disease or condition.

References

  1. 1 2 Ewald, Nils; Hardt, Philip D (2013-11-14). "Diagnosis and treatment of diabetes mellitus in chronic pancreatitis". World Journal of Gastroenterology. 19 (42): 7276–7281. doi: 10.3748/wjg.v19.i42.7276 . ISSN   1007-9327. PMC   3831209 . PMID   24259958.
  2. ↑ Hart, PA; Bellin, MD; Andersen, DK; Bradley, D; Cruz-Monserrate, Z; Forsmark, CE; Goodarzi, MO; Habtezion, A; Korc, M; Kudva, YC; Pandol, SJ; Yadav, D; Chari, ST; Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic, Cancer(CPDPC). (November 2016). "Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer". The Lancet. Gastroenterology & Hepatology. 1 (3): 226–237. doi:10.1016/S2468-1253(16)30106-6. PMC   5495015 . PMID   28404095.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  3. ↑ "Diabetes in Chronic Pancreatitis". Medscape. Anand R. Gupte and Chris E. Forsmark. Retrieved 2016-07-09.
  4. ↑ "Study shows molecular mechanism behind type 3c pancreatic diabetes". News Medical. August 29, 2012. Retrieved July 9, 2016.
  5. ↑ Venturi, Sebastiano (January 2021). "Cesium in Biology, Pancreatic Cancer, and Controversy in High and Low Radiation Exposure Damage—Scientific, Environmental, Geopolitical, and Economic Aspects". International Journal of Environmental Research and Public Health. 18 (17): 8934. doi: 10.3390/ijerph18178934 . PMC   8431133 . PMID   34501532. CC-BY icon.svg Text was copied from this source, which is available under a Creative Commons Attribution 4.0 International License.
  6. ↑ Venturi, Sebastiano (November 2023). "Correlation of Diabetes, Salivary Gland Cancer and Pancreatic Cancerwith Iodine and Cesium Radionuclides" (PDF). Austin J Gastroenterol. 10 (1).
  7. 1 2 Quast, Daniel Robert; Breuer, Thomas Georg Karl; Nauck, Michael Albrecht; Janot-Matuschek, Monika; Uhl, Waldemar; Meier, Juris Jendrik (April 2021). "Insulinbedarf und Glukosehomöostase bei Menschen nach partieller und totaler Pankreatektomie im Vergleich zu Menschen mit anderen Diabetesformen". Diabetologie und Stoffwechsel. 16 (2): 130–140. doi:10.1055/a-1344-0323. S2CID   233938736.
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