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Treatment Of Pancreatogenic Diabetes

Pancreatogenic Diabetes After Pancreatic Resection

Pancreatogenic Diabetes After Pancreatic Resection

Volume 11, Issue 2 , August 2011, Pages 268-276 Pancreatogenic Diabetes after Pancreatic Resection Author links open overlay panel HiromichiMaedaab KazuhiroHanazakia1 Get rights and content The loss of pancreatic parenchyma resulting from pancreatic resection causes an extreme disruption of glucose homeostasis known as pancreatogenic diabetes. This form of glucose intolerance is different from the other forms of diabetes mellitus in that affected individuals suffer frequent episodes of iatrogenic hypoglycemia. The development of sophisticated surgical procedures, improved postoperative care, and the capacity for early diagnosis of disease has prolonged life expectancy after pancreatic resection. For this reason, pancreatogenic diabetes is now attracting attention as the primary factor influencing quality of life in patients who have undergone this procedure. The incidence of new-onset diabetes mellitus after pancreatic resection increases as the follow-up period after surgery becomes longer and is related to the progression of underlying disease, the type of surgery, and the extent of resection. The pathophysiology of pancreatogenic diabetes is related to pancreatic hormone deficiency and the altered responses of the liver and peripheral organs to lower than normal hormone levels. Hyperglycemia occurs when the amount of insulin produced or administered is insufficient because of unsuppressed hepatic glucose production secondary to a deficiency in pancreatic polypeptide. In contrast, patients lapse into hypoglycemia when insulin is barely excessive because of enhanced peripheral insulin sensitivity and glucagon deficiency. Nutritional state, pancreatic exocrine function and intestinal function also affect glycmic control. Insulin replacement is considered to be the main Continue reading >>

Clinical Aspects Of Pancreatogenic Diabetes Secondary To Hereditary Pancreatitis

Clinical Aspects Of Pancreatogenic Diabetes Secondary To Hereditary Pancreatitis

Abstract Hereditary pancreatitis is a rare inherited form of pancreatitis, characterized by recurrent episodes of acute pancreatitis with early onset and/or chronic pancreatitis, and presenting brittle diabetes, composed of episodes of nonketotic hyperglycemia and severe hypoglycemia. The existing literature regarding this form of diabetes is scarce. In this report, clinical features of pancreatogenic diabetes secondary to hereditary pancreatitis are presented along with recommendations for appropriate medical treatment. Clinical data from five patients of a family with pancreatogenic diabetes secondary to hereditary pancreatitis were analyzed. The average time between hereditary pancreatitis and diabetes diagnosis was 80 ± 24 months (range: 60–180 months) with a mean age of 25.6 ± 14.7 years (range: 8–42 years), four patients used antidiabetic agents for 46 ± 45 months and all progressed to insulin therapy with a mean dose of 0.71 ± 0.63 IU/kg (range: 0.3–1.76 IU/kg). The glycemic control had a high variability with average capillary blood glucose of 217.00 ± 69.44 mg/dl (range: 145–306 mg/dl) and the average HbA1c was 9.9 ± 1.9% (range: 7.6–11.6%). No ketoacidosis episodes occurred and there were several episodes of hospitalization for severe hypoglycemia. Diabetes mellitus secondary to hereditary pancreatitis presents with early onset, diverse clinical presentation and with extremely labile glycemic control. Diabetes treatment varies according to the presentation and insulin is frequently necessary for glycemic control. Background Hereditary pancreatitis (HP) is a rare autosomal dominant disease characterized by recurrent episodes of acute pancreatitis that leads to permanent chronic pancreatitis. Common clinical manifestations are: abdominal pain, di Continue reading >>

Payperview: Pancreatogenic Diabetes: Special Considerations For Management - Karger Publishers

Payperview: Pancreatogenic Diabetes: Special Considerations For Management - Karger Publishers

I have read the Karger Terms and Conditions and agree. Background/Aims: Pancreatogenic, or type 3c, diabetes (T3cDM) occurs due to inherited or acquired pancreatic disease or resection. Although similar to the more prevalent type 1 and type 2 diabetes, pancreatogenic diabetes has a unique pattern of hormonal and metabolic characteristics and a high incidence of pancreatic carcinoma in the majority of patients with T3cDM. Despite these differences, no guidelines for therapy have been described. Methods: Published studies on the prevalence, pathophysiology, and cancer associations of T3cDM were reviewed. The recent studies on the protective role and mechanism of metformin therapy as both an anti-diabetic and anti-neoplastic agent were reviewed, and studies on the cancer risk of other anti-diabetic drugs were surveyed. Results: T3cDM accounts for 510% of Western diabetic populations and is associated with mild to severe disease. Hepatic insulin resistance is characteristic of T3cDM and is caused by deficiencies of both insulin and pancreatic polypeptide. 75% of T3cDM is due to chronic pancreatitis, which carries a high risk for pancreatic carcinoma. Insulin and insulin secretagogue treatment increases the risk of malignancy, whereas metformin therapy reduces it. Pancreatic exocrine insufficiency associated with T3cDM contributes to nutritional deficiencies and the development of metabolic bone disease. Conclusions: Until consensus recommendations are reached, the glycemic treatment of T3cDM should avoid insulin and insulin secretagogues if possible. Metformin should be the first line of therapy, and continued if insulin treatment must be added for adequate glucose control. Pancreatic enzyme therapy should be added to prevent secondary nutritional and metabolic complicatio Continue reading >>

Type 3c (pancreatogenic) Diabetes

Type 3c (pancreatogenic) Diabetes

Pancreatogenic diabetes or type 3c diabetes is a form of secondary diabetes, associated with a primary disorder of the exocrine portion of the pancreas. What is Type 3c (Pancreatogenic) Diabetes? Pancreas - Overview of Structure and Function Types of Diabetes Mellitus What are the Causes of Type 3c (Pancreatogenic) Diabetes? What are the Symptoms of Type 3c (Pancreatogenic) Diabetes? How do you Diagnose Type 3c (Pancreatogenic) Diabetes? How do you Treat Type 3c (Pancreatogenic) Diabetes? How do you Prevent Type 3c (Pancreatogenic) Diabetes? Frequently Asked Questions Glossary References What is Type 3c (Pancreatogenic) Diabetes? Pancreatogenic or type 3c diabetes mellitus is a form of secondary diabetes wherein the primary disease is in the exocrine portion of the pancreas and predates the development of diabetes. It is suggested that between 5-10% of all diabetics may have pancreatogenic diabetes. Interestingly nearly 80 percent of pancreatogenic diabetes is caused by chronic pancreatitis. The exact figures are not known as data remains scarce and frequently patients with pancreatic diabetes are misclassified. Only recently have diagnostic criteria been proposed for pancreatogenic diabetes, enabling accurate diagnosis and appropriate management of the condition. Pancreas - Overview of Structure and Function The pancreas is an important organ found in the abdominal cavity. It is elongated and tapering and is situated behind the stomach. The pancreas is structurally divided into four parts namely head, neck body and tail. Functionally, it is divided into two portions, the exocrine portion and the endocrine portion. The exocrine portion occurs predominantly in the head, neck and body and consists of glands that secrete digestive juices which travel to the small intestin 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 >>

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 >>

What Is Type 3c (pancreatogenic) Diabetes? Causes, Complications & Treatment

What Is Type 3c (pancreatogenic) Diabetes? Causes, Complications & Treatment

What is Type 3C (Pancreatogenic) Diabetes? Causes, Complications & Treatment What is Type 3C (Pancreatogenic) Diabetes? Causes, Complications & Treatment People are aware of the two main types of diabetes, type 1 and type 2 and the complications that these involve. However, not many are aware that there exists another type of diabetes known as Pancreatogenic diabetes or type 3c. In this article, we shall try to find out more about this type. So, come and join in for the article What is Type 3C (Pancreatogenic) Diabetes? Its Causes, Complications, & Treatment. This is a type of diabetes which is mainly associated with the exocrine pancreas. It also has to do with the digestive functions of the organ. The Pancreatogenic diabetes is actually considered to be a secondary form of diabetes. When you have problems associated with the exocrine pancreas, you more often than not suffer from what is known as chronic pancreatitis. Pancreatogenic diabetes, which is also known as type 3c diabetes mainly results from destruction of the normal functioning of the pancreas that is a result of inflammation of the pancreas, surgery, as well as various types of tumors caused in the pancreas. What are the Causes of Pancreatogenic Diabetes? The major causes of the type 3c diabetes are being researched by the experts. However, there are a few known causes of the condition and the same is explained in the section that follows. The following are a few major causes of the same: Dysfunction of the digestive organs and malnutrition in the individuals Resection of the pancreas which mainly results from either pancreatic cancer or due to some cystic lesions in the organ Patients with pancreatic exocrine insufficiency also tend to get the problem Must Read: What is Hyperglycemia (High Blood Sugar)? C 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 >>

What Is Type 3c Diabetes?

What Is Type 3c Diabetes?

2nd November 3027 -- Most people have heard of type 1 and type 2 diabetes but now concerns are being raised about under-diagnosis of a newly identified form of the condition - known as type 3c. According to researchers from the University of Surrey, the failure of doctors to recognise this form of diabetes is putting patients' health at risk. What is type 3c diabetes? Type 3c diabetes occurs as a result of pancreatic disease or injury sometimes many years prior to a diabetes diagnosis, which affects the body's ability to produce insulin. It is also sometimes called 'pancreatogenic diabetes' or 'diabetes of the exocrine pancreas'. Type 3c diabetes is associated with poor glycaemic control and early insulin therapy. In type 1 diabetes the immune system mistakenly attacks healthy body tissue in the pancreas preventing the creation of insulin. It always needs insulin treatment. Type 2 diabetes, the most common form of diabetes, is associated with obesity and occurs when the body doesn't produce enough insulin to function properly, or the body's cells don't react to insulin correctly. Patients with this form of diabetes may be treated with diet and medication but may eventually need insulin injections. New study and findings In the first ever study of its kind, researchers from the University of Surrey, examined the anonymised GP records of more than 2 million people, looking at the frequency of different types of diabetes and the accuracy of diagnosis. They discovered that up to 97.3% of people who have previously experienced pancreatic disease are misdiagnosed, typically with type 2 diabetes, rather than the correct condition type 3c. Researchers also discovered that adults were more likely to develop type 3c diabetes than type 1 diabetes making it more common than previou Continue reading >>

Pancreatogenic Diabetes

Pancreatogenic Diabetes

Pancreatogenic diabetes, also known as Type 3C diabetes, results from pancreatic disease (such as chronic pancreatitis) or surgery on the pancreas. A grayish pink gland located in the abdomen, the pancreas essentially has a dual function: The exocrine pancreas secretes important digestive enzymes into the gastrointestinal tract, while the endocrine pancreas secretes the hormones insulin and glucagon into the bloodstream to regulate carbohydrate metabolism. In diabetes, the beta cells of the pancreas no longer make enough insulin to meet the body’s needs, leading to elevated levels of glucose in the blood. Even though diabetes is primarily a disease of the endocrine pancreas, scientists now know that diseases of the exocrine pancreas — or surgery on the pancreas — can also lead to diabetes. They have dubbed this type of diabetes pancreatogenic diabetes, or Type 3C diabetes. Chronic pancreatitis (inflammation of the pancreas), hemochromatosis (a disease of iron metabolism), cystic fibrosis (an inherited disorder of the pancreas and other exocrine glands that produces abnormally thick secretions), pancreatic cancer, and previous surgery on the pancreas have all been associated with diabetes. It is estimated that Type 3C diabetes accounts for 5% to 10% of diabetes diagnoses in western populations and that chronic pancreatitis accounts for 75% of this type of diabetes. Scientists are still trying to figure out exactly what causes pancreatogenic diabetes. They have noted that a single genetic mutation can impair both endocrine and exocrine functions of the pancreas. Furthermore, certain pancreatic diseases can disturb the regeneration of beta cells within the pancreas that manufacture and secrete insulin, thus causing diabetes in patients with chronic pancreatitis. Scie Continue reading >>

A Novel Peptide Nanomedicine For Treatment Of Pancreatogenic Diabetes - Sciencedirect

A Novel Peptide Nanomedicine For Treatment Of Pancreatogenic Diabetes - Sciencedirect

Volume 9, Issue 6 , August 2013, Pages 722-728 A novel peptide nanomedicine for treatment of pancreatogenic diabetes Author links open overlay panel AmritaBanerjeePhDa HayatOnyukselPhDab Get rights and content Pancreatogenic diabetes (PD) is a potentially fatal disease that occurs secondary to pancreatic disorders. The current anti-diabetic therapy for PD is fraught with adverse effects that can increase morbidity. Here we investigated the efficacy of novel peptide nanomedicine: pancreatic polypeptide (PP) in sterically stabilized micelles (SSM) for management of PD. PP exhibits significant anti-diabetic efficacy but its short plasma half-life curtails its therapeutic application. To prolong and improve activity of PP in vivo, we evaluated the delivery of PP in SSM. PP-SSM administered to rats with PD, significantly improved glucose tolerance, insulin sensitivity and hepatic glycogen content compared to peptide in buffer. The studies established the importance of micellar nanocarriers in protecting enzyme-labile peptides in vivo and delivering them to target site, thereby enhancing their therapeutic efficacy. In summary, this study demonstrated that PP-SSM is a promising novel anti-diabetic nanomedicine and therefore should be further developed for management of PD. Pancreatic peptide was earlier demonstrated to address pancreatogenic diabetes, but its short half-life represented major difficulties in further development for therapeutic use. PP-SSM (pancreatic polypeptide in sterically stabilized micelles) is a promising novel anti-diabetic nanomedicine that enables prolonged half-life and increased bioactivity of PP, as shown in this novel study, paving the way toward clinical studies in the near future. Pancreatic polypeptide associated with sterically stabilized pho 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 >>

Diabetes And Pancreatic Cancer

Diabetes And Pancreatic Cancer

Department of Surgery, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA 1Department of Surgery, Nankai Clinical School of Medicine, Tianjin Nankai Hospital, Tianjin Medical University, Tianjin, China (Correspondence should be addressed to D K Andersen who is now at Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Building DEM2, Room 659, 6707 Democracy Boulevard, Bethesda, Maryland 20892, USA; Email: andersendk{at}niddk.nih.gov) Epidemiological studies clearly indicate that the risk of pancreatic cancer (PC) is increased in diabetic patients, but most studies focus on overall diabetes or type 2 diabetes mellitus (T2DM), and there are few studies on the risks of type 1 and type 3c (secondary) diabetes. Possible mechanisms for increased cancer risk in diabetes include cellular proliferative effects of hyperglycemia, hyperinsulinemia, and abnormalities in insulin/IGF receptor pathways. Recently, insulin and insulin secretagogues have been observed to increase the PC risk, while metformin treatment reduces the cancer risk in diabetic subjects. In addition, anticancer drugs used to treat PC may either cause diabetes or worsen coexisting diabetes. T3cDM has emerged as a major subset of diabetes and may have the highest risk of pancreatic carcinoma especially in patients with chronic pancreatitis. T3cDM is also a consequence of PC in at least 30% of patients. Distinguishing T3cDM from the more prevalent T2DM among new-onset diabetic patients can be aided by an assessment of clinical features and confirmed by finding a deficiency in postprandial pancreatic polypeptide release. In conclusion, diabetes and PC have a complex rela Continue reading >>

How To Treat Pancreatogenic Diabetes?

How To Treat Pancreatogenic Diabetes?

On one side, having an unsuppressed glucose production from the liver, he will continuously have high glycemia levels excursions. On the other side, glucagon in not produced anymore and the peripheral insulin sensitivity is increased due to lack of insulin. Therefore it is very easy to suffer hypoglycemia events. I must admit that insulin treatment will be problematic, but you have to stick to it. He needs small doses of course, because his insulin sensitivity is increasing. A1c is high not only because of nonmanagement of hyperglycemia, but also because of the the effects of the anti-insulin hormones, excluding glucagone in this case. Metformin may do more harm than good in this case. It will slow down the hepatic gluconeogenesis but also it will increase the glycolysis in the peripheral tissues, which is a bad idea in cases with frequent hypoglycemia. Do not forget that metformin also decreases levels of glucagon that could be given exogenously in severe cases of hypoglicemia, making it more difficult to deal with. 1. Avoid hypoglycemia (No skipping meals; Frequent small meals; Continuous glicemia measurements, especially after physical activity; No alcohol; Keeping glucagone with him always; Instruct a family member how to use glucagon) 3. Last but not least, pay attention to malnutrition. Because of the lack of exocrine pancreatic enzymes, your patient will have lots of malnutrition related problems. These problems can also reflect themselves in the hypo-hyper levels of glycemia he is suffering from. 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 >>

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