Diabetes of exocrine pancreas


Authors: Rid Dravecká
Authors‘ workplace: I. interná klinika LF UPJŠ a UNLP Košice
Published in: Forum Diab 2020; 142(3): 184-190
Category:

Overview

Diabetes mellitus is a group of diseases defined by persistent hyperglycemia. Causes of diabetes include also exocrine pancreatic diseases. Exocrine pancreatic diseases lead to diabetes by varying mechanisms of hyperglycemia. The most common causes are chronic pancreatitis, pancreatic ductal adenocarcinoma, hemochromatosis, cystic fibrosis, and previous pancreatic surgery. Recent literature refers to it as type 3 diabetes. It´s prevalence and clinical importance have been underestimated. The early identification of pancreatogenic diabetes and distinction from the more prevalent type 2 diabetes is clinically significant. Possible mechanisms for increased cancer risk in diabetes include cellular proliferative effects of hyperglycemia, hyperinsulinemia, and abnormalities in insulin/IGF receptor pathways. Despite its differences, no guidelines for therapy have been described. Metformin promotes a survival benefit in individuals with post-pancreatitis diabetes mellitus but not with pancreatic cancer related diabetes. Reverse causality may play a role in the association between insulin use and mortality in pancreatic cancer related diabetes. Metformin treatment reduces the cancer risk in diabetic subjects.

Keywords:

diabetes mellitus 3c type – exocrine pancreas – insulin use – metformin – Pancreatitis


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Labels
Diabetology Endocrinology Internal medicine
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