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 t...

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Veröffentlicht in:Diabetes care 2008-02, Vol.31 (Supplement 2), p.S165-S169
Hauptverfasser: Hardt, Philip D, Brendel, Mathias D, Kloer, Hans U, Bretzel, Reinhard G
Format: Artikel
Sprache:eng
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Zusammenfassung: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.
ISSN:0149-5992
1935-5548
DOI:10.2337/dc08-s244