A recent article explains the importance of correctly diagnosing diabetes of the exocrine pancreas, also known as type 3c diabetes.
Type 3c diabetes is a disorder of the pancreas. It is usually caused by disease or a structural change in the pancreas. In contrast, type 1 diabetes occurs when the pancreas does not produce enough insulin. Type 2 diabetes occurs primarily when the body does not properly manage the insulin produced by the body.
As recently discussed in the British Medical Journal, researchers reviewed primary care records for over two million patients in England for cases of adult-onset diabetes to identify which patients had pancreatic disease prior to their diabetes diagnosis. The review was for the period between January 1, 2005, and March 31, 2016. The results of the review show that 87.8% of the type 3c diabetes diagnoses were documented as type 2 diabetes.
Patients with type 3c diabetes had poorer glycemic (blood sugar) control than patients with type 2 diabetes. The patients with type 3c diabetes were also more likely to require insulin within five years of diagnosis. The researchers recommend that physicians consider pancreatic disease when diagnosing diabetes and design the treatment approach and monitoring schedule as appropriate for this group. Monitoring of treatment goals will need to be done more frequently than in patients with type 2 diabetes.
Since the pancreas produces insulin, any change to the structure and function of the pancreas, either through disease or surgery, can alter its ability to produce insulin to meet the body’s requirements. This is why patients with type 3c diabetes tend to require insulin supplementation earlier than patients with type 2 diabetes. Correctly diagnosing the type of diabetes provides the patient and healthcare team with the tools required for optimal disease management.
Written by Anuolu Bank-Oni, Pharm.D,CDE
Mayor, S. Type 3c diabetes associated with pancreatic disease is often misdiagnosed, finds study. BMJ 2017;359:j4923 doi: 10.1136/bmj.j4923