Diabetes mellitus secondary to chronic pancreatitis (clinical case)

• Vugar R. Gadzhiev

Abstract

Among patients with diabetes mellitus, the vast majority are patients with type 1 and type 2 diabetes mellitus (DM). However, diabetes can also develop as a direct consequence of other diseases, including diseases of the exocrine pancreas. This type of diabetes includes diabetes mellitus as a result of hemochromatosis, cystic fibrosis, tumors or surgical interventions on the pancreas, but the most common cause is pancreatitis, both acute and chronic.

There are no clear diagnostic criteria for this special type of diabetes. This circumstance leads to the fact that patients are mistakenly diagnosed with DM1 or DM2, So the management is not always adequate and safe.

This article presents a clinical case of a patient with diabetes secondary to chronic pancreatitis. Therapy was selected taking into account the particularities of the disease progression.

Keywords:pancreatogenous diabetes mellitus; diabetes mellitus; chronic pancreatitis

References

1. Hart P.A., Bellin M.D., Andersen D.K., et al. Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol. 2016; 1 (3): 226-37.

2. Schrader H., Menge B.A., Schneider S., et al. Reduced pancreatic volume and beta-cell area in patients with chronic pancreatitis. Gastroenterology. 2009; 136 (2): 513-22.

3. Ewald N. Diagnosis and treatment of diabetes mellitus in chronic pancreatitis. World J Gastroenterol. 2013; 19 (42): 7276.

4. Czako L., Hegyi P., Rakonczay Z., et al. Interactions between the Endocrine and exocrine pancreas and their clinical relevance. Pancreatology. 2009; 9 (4): 351-9.

5. Brunicardi F.C., Chaiken R.L., Ryan A.S., et al. Pancreatic polypeptide administration improves abnormal glucose metabolism in patients with chronic pancreatitis. J Clin Endocrinol Metab. 1996; 81 (10): 3566-72.

6. Makuc J. Management of pancreatogenic diabetes: challenges and solutions. Diabetes Metab Syndr Obes. 2016; 9: 311-5.

7. Knop F.K., Vilsbøll T., Højberg P.V., et al. The insulinotropic effect of GIP is impaired in patients with chronic pancreatitis and secondary diabetes mellitus as compared to patients with chronic pancreatitis and normal glucose tolerance. Regul Pept. 2007; 144 (1-3): 123-30.

8. Cui Y., Andersen D.K. Pancreatogenic diabetes: special considerations for management. Pancreatology. 2011; 11 (3): 279-94.

9. Lin Y.K., Johnston P.C., Arce K., Hatipoglu B.A. Chronic pancreatitis and diabetes mellitus. Curr Treat Options Gastroenterol. 2015; 13 (3): 319-31.

10. Grotta R. La, Candia P. de, Olivieri F., et al. Anti-inflammatory effect of SGLT‑2 inhibitors via uric acid and insulin. Cell Mol Life Sci. 2022; 79 (5): 273.

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