Pancreatogenic Diabetes Mellitus – Type 3c (T3cDM)

Abstract

Pancreatogenic diabetes mellitus (type 3c diabetes, T3cDM) is a distinct form of diabetes resulting from primary pancreatic disorders, most commonly chronic pancreatitis. It involves both - endocrine and exocrine dysfunction, leading to unstable glycemia with frequent hypo-and hyperglycemia. The condition is often underdiagnosed despite its notable prevalence in patients with pancreatic disease, including malignancy and post-surgical states. Clinically, it overlaps with type 1 and type 2 diabetes but is distinguished by malabsorption and weight loss. Diagnosis requires standard glycemic criteria alongside evidence of pancreatic pathology and exclusion of other diabetes types. Management combines lifestyle measures, pancreatic enzyme replacement, and primarily insulin therapy, with metformin in selected cases. Early recognition is crucial due to its association with pancreatic cancer and increased risk of microvascular complications.