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Diabetes Type C

Pancreatogenic (type 3c) Diabetes

Pancreatogenic (type 3c) Diabetes

1. Definition Pancreatogenic diabetes is a form of secondary diabetes, specifically that associated with disease of the exocrine pancreas. The most common disease of the exocrine pancreas associated with the development of diabetes is chronic pancreatitis. Analogous to chronic pancreatitis-associated diabetes is cystic fibrosis-related diabetes (CFRD), in which pancreatic exocrine insufficiency pre-dates the pancreatic endocrine insufficiency responsible for the development of diabetes. Because diabetes in cystic fibrosis is associated with worse nutritional status, more severe inflammatory lung disease, and greater mortality from respiratory failure, CFRD has long been recognized as a distinct form of diabetes requiring a specified approach to evaluation and treatment (30) now recognized by the American Diabetes Association (28). While the distinct pathogenesis of diabetes in chronic pancreatitis has also long been appreciated, only recently have guidelines been developed supporting a specified diagnostic and therapeutic algorithm (37). Finally, other less common forms of pancreatogenic diabetes exist, such as that due to pancreatic cancer (18), as well as post-pancreatectomy diabetes, with each requiring individualized approaches to care. 2. Classification Pancreatogenic diabetes is classified by the American Diabetes Association and by the World Health Organization as type 3c diabetes mellitus (T3cDM) and refers to diabetes due to impairment in pancreatic endocrine function related to pancreatic exocrine damage due to acute, relapsing and chronic pancreatitis (of any etiology), cystic fibrosis, hemochromatosis, pancreatic cancer, and pancreatectomy, and as well rare causes such as neonatal diabetes due to pancreatic agenesis (1). Prevalence data on T3cDM are scarce b Continue reading >>

Type 3c Diabetes Commonly Mistaken For Type 2 Diabetes - Study

Type 3c Diabetes Commonly Mistaken For Type 2 Diabetes - Study

According to British researchers, there is a third kind of diabetes that has until now been misdiagnosed as type 2 diabetes. It is termed type 3c diabetes mellitus write the researchers in the November issue of the journal Diabetes Care. The researchers have found that there are 31,789 new cases of diabetes that are being diagnosed over the decade of their study. Of these, 1.5 percent has been diagnosed as type 2 diabetes when they should have been diagnosed as type 3c. A further 1 percent of type 3 diabetics were mistakenly diagnosed as having type 1 diabetes. Of all the patients, 559 cases were due to previous pancreatic trauma. Of these 87.8 percent were misdiagnosed as having type 2 diabetes when they actually had type 3c diabetes. Less than 3 percent were correctly diagnosed as having type 3c diabetes say the researchers. According to their study, type c form of diabetes is different from types 1 and 2. Types of diabetes Diabetes is one of the leading causes of death and disease worldwide. According to the Centers for Disease Control and Prevention, CDC, it is the seventh leading cause of death in the US. The condition results from inadequate insulin hormone released from the pancreas. This leads to high blood sugar that can damage several organs including the kidneys, eyes, heart and the nerves. Diabetes affects 30.3 million Americans and of these 90-95 percent have type 2 diabetes says the CDC. Diabetes is still undiagnosed in around 7.2 million people, they add. Type 1 diabetes forms when the body develops antibodies that kill the beta cells of the pancreas that normally produce insulin hormone. This leads to lack of essential hormone insulin in the body. The person thus is unable to handle the blood sugar leading to diabetes and its complications. This is usual Continue reading >>

What Is Type 3c Diabetes?

What Is Type 3c Diabetes?

A group of scientists is warning that doctors need to be more aware of a type of diabetes that has been newly studied in recent years, which they say is poorly understood by many doctors and commonly misdiagnosed. As a result, patients with this form of diabetes, called Type 3c, often aren’t getting the treatment they need. By way of review: Type 1 diabetes, which often shows up in childhood or early adulthood, is an autoimmune disease affecting the insulin-producing cells of the pancreas. Type 2 diabetes, which has generally been associated with middle-aged and older people, is caused by the body’s inability to use insulin properly. Type 3c, described in a new study in the journal Diabetes Care, stems from damage to a previously healthy pancreas, caused by such health issues as pancreatitis, a pancreatic tumor, cystic fibrosis or trauma. As a result, the pancreas no longer produces adequate amounts of insulin, digestive enzymes and other hormones. According to some earlier journal articles on Type 3c, most of the cases occur among people with chronic pancreatitis. Yet, according to the study by a group of British scientists, doctors routinely mistake Type 3c diabetes for Type 2. Writing in the website The Conversation, one of the researchers said the study found that only 3 percent of people with Type 3c diabetes were correctly diagnosed. The mistake can be mean they’re not getting the treatment they need. “Small studies in specialist centers have found that most people with Type 3c diabetes need insulin and, unlike other diabetes types, can also benefit from taking digestive enzymes with food,” wrote the researcher, Andrew McGovern at the University of Surrey. In order to find patients with Type 3c, the researchers looked at close to 38,000 adult patients wh Continue reading >>

Management Of Pancreatogenic Diabetes: Challenges And Solutions

Management Of Pancreatogenic Diabetes: Challenges And Solutions

Go to: Introduction Pancreatogenic diabetes is a form of secondary diabetes, classified by the American Diabetes Association (ADA) and the World Health Organization as type 3c diabetes mellitus (T3cDM).1,2 It refers to diabetes due to diseases of the exocrine pancreas: pancreatitis (acute, relapsing, or chronic pancreatitis of any etiology), pancreatectomy/trauma, neoplasia, cystic fibrosis, hemochromatosis, and fibrocalculous pancreatopathy.3 With the exception of cancer, damage to the pancreas must be extensive enough for diabetes to occur.1,2 Rather scarce data on T3cDM suggest that most cases result from chronic pancreatitis, as this condition was identified as the underlying disease in 78.5% of all patients with T3cDM.4 In Western populations, T3cDM is estimated to occur in 5%–10% of all diabetic patients, mostly due to chronic pancreatitis.4–6 True prevalence of T3cDM is unknown – data are scarce, mostly due to challenges with accurate diabetes classification in clinical practice.4,7–9 Many T3cDM patients are initially misclassified due to underrecognized contribution of pancreatic disease to the development of diabetes. In order to improve diagnosis, diagnostic criteria for T3cDM have been proposed by Ewald and Bretzel which include 1) the presence of pancreatic exocrine insufficiency, 2) evidence of pathological pancreatic imaging, and 3) the absence of type 1 diabetes mellitus (T1DM)-associated autoantibodies.6 They may be further supported by additional minor criteria, such as an absent pancreatic polypeptide (PP) response to mixed-nutrient ingestion.6 These criteria may be more reliably applied at the presentation of diabetes due to a degree of overlap in established insulin deficiency (related to pancreatic atrophy and exocrine insufficiency). It is Continue reading >>

Type 3c (pancreatogenic) Diabetes

Type 3c (pancreatogenic) Diabetes

Type 3c diabetes (also known as Pancreatogenic diabetes) is a form of diabetes that is being researched. It involves the exocrine and digestive functions of the pancreas. Out of all the diabetics, 5–10% may actually be type 3c diabetics. In 80% of people who suffer from this condition, chronic pancreatitis seems to be the cause.[1] Presentation[edit] Complications[edit] 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. Cause[edit] There are multiple causes. Some of which identified are: Pancreatic disease Pancreatic resection Chronic pancreatitis (caused by exocrine insufficiency, maldigestion, and malnutrition).[2] Lacking genes in the E2F group.[3] More possible causes are being researched. Diagnosis[edit] 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: Imparied 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[edit] The condition can be managed by many factors. Lifestyle Modifications[edit] Avoiding toxins to the body such as alcohol and smoking reduce pancreatic inflammation. Also, eat Continue reading >>

Awareness Of Type 3c Diabetes And Why It Is Misdiagnosed

Awareness Of Type 3c Diabetes And Why It Is Misdiagnosed

Diabetes has long been divided into type 1 and type 2. But a third type has entered the mix — and we aren’t diagnosing it correctly. Type 1 diabetes occurs when the pancreas doesn’t produce insulin and is usually diagnosed at a young age. Type 2 diabetes shows up later in life when the pancreas can’t make enough insulin to keep up with the body. This new third type, Type 3c, starts with a damaged pancreas. The researchers say that pancreatitis is leading to misdiagnoses of type 2 diabetes in people who actually have type 3c diabetes. A new study involving two million people has found 97.3% of those who had previously suffered from pancreatic disease (acute pancreatitis or chronic pancreatic disease) had been wrongly diagnosed with type 2 diabetes when, in fact, they actually had type 3c diabetes, despite a sevenfold increased insulin requirement within 5 years, by which time 45.8% of patients with diabetes following chronic pancreatic disease are using insulin. Type 3c diabetes, also known as pancreatogenic diabetes, is not as well known compared to type 1 and type 2 diabetes. It develops when the pancreas becomes inflamed, or part of it is removed and eventually stops producing insulin. A recent study from the American Diabetes Association found only 3 percent of people with type 3c have actually received a correct diagnosis. These misdiagnoses mean people with type 3c might not be getting effective treatments. People diagnosed with type 3c require insulin, but may also benefit from taking digestive enzyme tablets, one of the study’s researchers wrote. That alternative treatment option is what sets type 3c apart from the other types. Correctly identifying the type of diabetes is important as it helps the selection of the correct treatment. Several drugs used Continue reading >>

Type 3c (pancreatogenic) Diabetes Mellitus Secondary To Chronic Pancreatitis And Pancreatic Cancer

Type 3c (pancreatogenic) Diabetes Mellitus Secondary To Chronic Pancreatitis And Pancreatic Cancer

Diabetes mellitus is a group of diseases defined by persistent hyperglycaemia. Type 2 diabetes, the most prevalent form, is characterised initially by impaired insulin sensitivity and subsequently by an inadequate compensatory insulin response. Diabetes can also develop as a direct consequence of other diseases, including diseases of the exocrine pancreas. Historically, diabetes due to diseases of the exocrine pancreas was described as pancreatogenic or pancreatogenous diabetes mellitus, but recent literature refers to it as type 3c diabetes. It is important to note that type 3c diabetes is not a single entity; it occurs because of a variety of exocrine pancreatic diseases with varying mechanisms of hyperglycaemia. The most commonly identified causes of type 3c diabetes are chronic pancreatitis, pancreatic ductal adenocarcinoma, haemochromatosis, cystic fibrosis, and previous pancreatic surgery. In this Review, we discuss the epidemiology, pathogenesis, and clinical relevance of type 3c diabetes secondary to chronic pancreatitis and pancreatic ductal adenocarcinoma, and highlight several important knowledge gaps. Continue reading >>

I Have Type 3c Diabetes – What Is That All About?

I Have Type 3c Diabetes – What Is That All About?

This week is #NationalDiabetesWeek and social media has been full of interesting facts and hints and tips on how to manage either Type 1 or Type 2 diabetes. What I have noticed though is that no-one has, thus far, mentioned Type 3 diabetes. This hasn’t come as a surprise. A year before I was diagnosed with operable pancreatic cancer, I was told that I may have Type 2 diabetes. However, I wasn’t overweight, nor did I have a family history of the disease. We now know that it was probably the cancer causing the blood sugar level elevations and this link between new-onset diabetes without weight gain (which can occur 1-3 years before a pancreatic cancer diagnosis) is something that we at Pancreatic Cancer Action are investigating in our research programmes. For all of these years (nearly 9) I have believed that I have Type 2 diabetes. However, at a recent consultation with my new Diabetologist, I discovered that I have in fact got Type 3c Diabetes. This I had never heard of before and so went about trying to find out more. I looked at some informed websites including Diabetes UK and found nothing. Not even a mention. And not all of the medical profession has heard of this type of diabetes either – unless they are specialists in this field. Never being one to give up, I kept on researching. I have since found out that, of all diabetes cases Type 3c makes up about 8%1 – not a lot, but not insignificant either. Type 3c Diabetes is usually characterised by the fact that the patient has had all or part of their pancreas resected due to cancer or cystic lesions or other diseases of the pancreas such as pancreatitis and cystic fybrosis.2 Patients often have Pancreatic Exocrine Insufficiency (malabsorption) and are on Pancreatic Enzyme Therapy (PERT) to help them get their Continue reading >>

What You Should Know About Pregestational Diabetes

What You Should Know About Pregestational Diabetes

Pregestational diabetes occurs when you have insulin-dependent diabetes before becoming pregnant. Pregestational diabetes has seven classes that depend on your age at diagnosis and certain complications of the disease. For example, your diabetes is class C if you developed it between the ages of 10 and 19. Your diabetes is also class C if you’ve had the disease for 10 to 19 years and you have no vascular complications. Having diabetes when you’re pregnant increases some risks for both you and your baby. The class of diabetes that you have tells your doctor about the severity of your diabetes. If you have diabetes, your pregnancy will need extra monitoring. The symptoms of diabetes include: excessive thirst and hunger frequent urination changes in weight blurry vision extreme fatigue Pregnancy can also cause symptoms such as frequent urination and fatigue. It’s important to monitor your glucose levels closely to help you and your doctor determine the reason for these symptoms. Your symptoms will have a lot to do with how well-controlled your diabetes is and how your pregnancy is progressing. The pancreas produces insulin. Insulin helps your body: use glucose, or sugar, and other nutrients from food store fat build up protein If your body doesn’t produce insulin or produces it inefficiently, then your blood glucose levels will be higher than normal and affect how your body functions. Type 1 diabetes occurs when your pancreas is unable to produce insulin. It can happen when your immune system mistakenly attacks your pancreas. It can also happen for unknown reasons. Researchers aren’t sure why people develop type 1 diabetes. You’re more likely to develop type 1 diabetes if you have a family history of the disease. People who have type 1 diabetes usually receive Continue reading >>

Is Pancreatic Diabetes (type 3c Diabetes) Underdiagnosed And Misdiagnosed?

Is Pancreatic Diabetes (type 3c Diabetes) Underdiagnosed And Misdiagnosed?

Exocrine pancreatic insufficiency is frequently associated with diabetes, with high prevalence in both insulin-dependent or insulin-independent patients. Exocrine pancreatic failure has often been perceived as a complication of diabetes. In contrast, recent clinical observations lead to the notion that nonendocrine pancreatic disease is a critical factor for development rather than a sequel to diabetes. The incidence of diabetes caused by exocrine pancreatic disease appears to be underestimated and may comprise 8% or more of the general diabetic patient population. Nonendocrine pancreas disease can cause diabetes by multiple mechanisms. Genetic defects have been characterized, resulting in a syndrome of both exocrine and endocrine failure. Regulation of β-cell mass and physiological incretin secretion are directly dependent on normal exocrine function. Algorithms for diagnosis and therapy of diabetes should therefore address both endocrine and exocrine pancreatic function. PREVALENCE OF PANCREATIC EXOCRINE INSUFFICIENCY IN PATIENTS WITH DIABETES— In recent years, the evaluation of exocrine pancreatic function has been greatly facilitated by newly available noninvasive stool tests allowing screening of large patient populations. Measurement of fecal elastase-1 concentrations (FECs) by enzyme-linked immunosorbent assay based on monoclonal human specific antibodies has become a standard diagnostic parameter with good correlation to direct tests of pancreatic exocrine function (12) and morphological pancreas alterations (13), albeit limited sensitivity in mild pancreatic exocrine insufficiency. Exocrine pancreatic function using FEC assessment has been extensively studied in patients with diabetes. Normal exocrine function (FEC >200 μg/g) was observed in ∼58% of patie Continue reading >>

C-peptide Test: Levels, Purpose, Procedure, And Results

C-peptide Test: Levels, Purpose, Procedure, And Results

The C-peptide test is a tool your doctor uses to monitor and treat diabetes . It shows how well your body makes insulin , which moves sugar (or glucose) from your blood into your cells. The test can help your doctor decide whether you need to take insulin to control your condition or to check your dosage if you already take it. Doctors can use the test whether you have type 1 diabetes , when the immune system attacks and destroys cells in the pancreas , or type 2, when your body doesn't use insulin as well it should. Beta cells in your pancreas make insulin. During that process, these cells also release C-peptide. This substance doesn't actually affect your blood sugar . But your doctor can measure the level of it to help her figure out how much insulin youre making. Doctors don't use it to actually diagnose diabetes , but it can give them a reading to help treat it. It can tell the difference between insulin your body has made and insulin that you took. To find out whether you have type 1 or type 2 diabetes When you have type 1 and your doctor needs to know how much insulin your pancreas still makes When you have type 2 diabetes and she needs to measure how much insulin you make on you own -- or whether you need to begin taking it yet To find out why you have low blood sugar (hypoglycemia) To diagnose a tumor of the pancreas that releases insulin, called an insulinoma You might need to stop eating 8 to 10 hours before the test. Sometimes, its done after you eat. Let your doctor know about any medicines you are on. Include medicine you take by prescription and those you buy over the counter, such as herbal supplements or vitamins. The C-peptide test uses a sample of your blood or urine . To take a blood test, someone in your doctors office or a lab places a needle into Continue reading >>

Diabetes Symptoms: Have You Been Misdiagnosed With Type 2? Signs You Have Type 3c

Diabetes Symptoms: Have You Been Misdiagnosed With Type 2? Signs You Have Type 3c

Diabetes sufferers are mostly made up of type 2, with 90 per cent of those diagnosed identified as having it compared to just 10 per cent with type 1. However, there is a now a third form of the condition - type 3c - and it is commonly being misdiagnosed as type 2. The University of Surrey discovered that, in adults, type 3c was more common than type 1, which affects 400,000 people in the UK. Unlike type 3c, the differences between type 1 and type 2 are well known. Type 3c, on the other hand, is caused by damage to the pancreas from inflammation of the pancreas, tumours of the pancreas, or pancreatic surgery. The former is where the body's immune system destroys the insulin producing cells of the pancreas. In the latter, the pancreas can't keep up with the insulin demand of the body. The result of both is that glucose - or sugar - levels can rise too high in the bloodstream, triggering diabetes symptoms such excessive thirst, unexplained weight loss and fatigue. Type 3c, on the other hand, is caused by damage to the pancreas from inflammation of the pancreas, tumours of the pancreas, or pancreatic surgery. Fri, August 19, 2016 Diabetes is a common life-long health condition. There are 3.5 million people diagnosed with diabetes in the UK and an estimated 500,000 who are living undiagnosed with the condition. This stops the pancreas from producing insulin, and also producing proteins needed to digest food and other hormones. A study by the University of Surrey has found that most cases of type 3c diabetes are being wrongly diagnosed as type 2 diabetes. Researchers discovered that in a sample of more than two million, just three per cent were correctly identified as having it. This is important since treatment may be slightly different for those with type 3c. Previous stud Continue reading >>

Newly Identified Diabetes Type 3c Getting Wrongly Diagnosed As Type 2 - Business Insider

Newly Identified Diabetes Type 3c Getting Wrongly Diagnosed As Type 2 - Business Insider

A vertical stack of three evenly spaced horizontal lines. * Copyright 2018 Insider Inc. All rights reserved. Registration on or use of this site constitutes acceptance of our A person receives a test for diabetes during Care Harbor LA free medical clinic in Los Angeles A new type of diabetes has been identified: type 3c. Type 3c is caused by pancreas damage as a result of inflammation, tumors, or surgery. A study shows that many doctors have been classifying Type 3c as Type 2 diabetes. Most people are familiar with type 1 and type 2 diabetes. Recently, though, a new type of diabetes has been identified: type 3c diabetes. Type 1 diabetes is where the body's immune system destroys the insulin producing cells of the pancreas. It usually starts in childhood or early adulthood and almost always needs insulin treatment. Type 2 diabetes occurs when the pancreas can't keep up with the insulin demand of the body. It is often associated with being overweight or obese and usually starts in middle or old age, although the age of onset is decreasing. Type 3c diabetes is caused by damage to the pancreas from inflammation of the pancreas (pancreatitis), tumors of the pancreas, or pancreatic surgery. This type of damage to the pancreas not only impairs the organ's ability to produce insulin but also to produce the proteins needed to digest food (digestive enzymes) and other hormones. However, our latest study has revealed that most cases of type 3c diabetes are being wrongly diagnosed as type 2 diabetes. Only 3% of the people in our sample - of more than 2m - were correctly identified as having type 3c diabetes. Small studies in specialist centers have found that most people with type 3c diabetes need insulin and, unlike with other diabetes types, can also benefit from taking digestiv Continue reading >>

Diagnosis And Treatment Of Diabetes Mellitus In Chronic Pancreatitis

Diagnosis And Treatment Of Diabetes Mellitus In Chronic Pancreatitis

Go to: INTRODUCTION Chronic pancreatitis is a disease characterized by pancreatic inflammatory and fibrotic injury resulting in irreversible parenchymal damage. Progressive nutrient maldigestion and disturbance of the timing and the interactions between nutrient digestion and absorption is observed and may lead to severe metabolic derangements. Glucose intolerance and diabetes mellitus are observed quite frequently in the course of the disease[1,2]. Development of diabetes mellitus in chronic pancreatitis mainly occurs due to the destruction of islet cells by pancreatic inflammation. Additionally, nutrient maldigestion leads to an impaired incretin secretion and therefore to a diminished insulin release of the remaining beta-cells[3]. In contrast to the autoimmune mediated destruction of the beta-cells in type 1 diabetes mellitus, glucagon secreting alpha-cells and pancreatic polypeptide secreting pancreatic polypeptide-cells are also subject to destruction in chronic pancreatitis leading to a complex deranged metabolic situation. Diabetes mellitus secondary to pancreatic diseases (such as chronic pancreatitis) is classified as pancreatogenic diabetes or type 3c diabetes mellitus according to the current classification of diabetes mellitus (Table 1)[4,5]. Whereas the awareness of type 1 and type 2 diabetes mellitus is rather good, type 3c diabetes mellitus, however, is a condition rarely considered in everyday practice. Yet, recent data on type 3c diabetes mellitus show that it might be more common than generally thought. Studies also suggest that this important condition might be consistently under- and misdiagnosed[6,7]. Due to the complex pathophysiology of type 3c diabetes mellitus it bears clinical and laboratory features which are very distinct from both type 1 an Continue reading >>

Type 3c Diabetes Is Commonly Misdiagnosed As Type 2

Type 3c Diabetes Is Commonly Misdiagnosed As Type 2

Most people have heard of type 1 and type 2 diabetes but nowconcerns are being raised about under-diagnosis of a newlyidentified form of the condition known as type 3c. According to researchers from the University of Surrey, thefailure of doctors to recognise this form of diabetes is puttingclients' health at risk. Type 3c diabetes occurs as a result of pancreatic disease orinjury sometimes many years prior to a diabetes diagnosis, whichaffects the body's ability to produce insulin. It is also sometimescalled "pancreatogenic diabetes" or "diabetes of the exocrinepancreas". Type 3c diabetes is associated with poor glycaemic control andearly insulin therapy. In type 1 diabetes the immune system mistakenly attacks healthybody tissue in the pancreas preventing the creation of insulin. Italways needs insulin treatment. Type 2 diabetes, the most common form of diabetes, occurs whenthe body doesn't produce enough insulin to function properly, orthe body's cells don't react to insulin correctly. Patients with this form of diabetes may be treated with diet andmedication but may eventually need insulin injections. In the first ever study of its kind, researchers from theUniversity of Surrey examined the anonymised GP records of morethan two million people, looking at the frequency of differenttypes of diabetes and the accuracy of diagnosis. They discovered that up to 97.3 per cent of people who havepreviously experienced pancreatic disease are misdiagnosed,typically with type 2 diabetes, rather than the correct conditiontype 3c. Researchers also discovered that adults were more likely todevelop type 3c diabetes than type 1 diabetes making it more commonthan previously thought. The findings have been published in the journal DiabetesCare. Misdiagnosing type 3c diabetes can have h Continue reading >>

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