Perspectives

Diabetes caused by pancreatic dysfunction: what you need to know

Annabelle M. Warren, Leon A. Bach

Figures

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© pixdesigne123/stock.adobe.com

Abstract

Chronic pancreatitis, pancreatic cancer and other pancreatic disorders can cause diabetes that may be insulin dependent. ‘Pancreatogenic’ diabetes underlies 2 to 10% of diabetes cases and has specific management implications, but is frequently misdiagnosed.

Key Points

  • Diabetes caused by pancreatic disease accounts for 2 to 10% of diabetes cases, and may be more common than type 1 diabetes.
  • The most common underlying cause is acute or chronic pancreatitis. Other causes include pancreatic cancer, surgical pancreatectomy, haemochromatosis and cystic fibrosis.
  • Clinical features that may raise suspicion for underlying pancreatic disease in a patient with diabetes include low/normal body weight or weight loss, negative type 1 diabetes antibodies and low serum C-peptide levels. Further tests such as faecal elastase level and abdominal imaging may assist diagnosis.
  • Insulin is the best treatment. Patients may also benefit from pancreatic enzyme and fat-soluble vitamin supplementation.

Figures

© pixdesigne123/stock.adobe.com
© pixdesigne123/stock.adobe.com