Detection, evaluation and treatment of diabetes mellitus in chronic pancreatitis: Recommendations from PancreasFest 2012
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Description Diabetes and glucose intolerance are common complications of chronic pancreatitis, yet clinical guidance on their detection, classification, and management is lacking.Methods A working group reviewed the medical problems, diagnostic methods, and treatment options for chronic pancreatitis-associated diabetes for a consensus meeting at PancreasFest 2012.Results Guidance Statement 1.1: Diabetes mellitus is common in chronic pancreatitis. While any patient with chronic pancreatitis should be monitored for development of diabetes, those with long-standing duration of disease, prior partial pancreatectomy, and early onset of calcific disease may be at higher risk. Those patients developing diabetes mellitus are likely to have co-existing pancreatic exocrine insufficiency. Guidance Statement 1.2: Diabetes occurring secondary to chronic pancreatitis should be recognized as pancreatogenic diabetes (type 3c diabetes). Guidance Statement 2.1: The initial evaluation should include fasting glucose and HbA1c. These tests should be repeated annually. Impairment in either fasting glucose or HbA1c requires further evaluation. Guidance Statement 2.2: Impairment in either fasting glucose or HbA1c should be further evaluated by a standard 75 g oral glucose tolerance test. Guidance Statement 2.3: An absent pancreatic polypeptide response to mixed-nutrient ingestion is a specific indicator of type 3c diabetes. Guidance Statement 2.4: Assessment of pancreatic endocrine reserve, and importantly that of functional beta-cell mass, should be performed as part of the evaluation and follow-up for total pancreatectomy with islet autotransplantation (TPIAT). Guidance Statement 3: Patients with pancreatic diabetes shall be treated with specifically tailored medical nutrition and pharmacologic therapies.Conclusions Physicians should evaluate and treat glucose intolerance in patients with pancreatitis.
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Patients with FCS who have experienced multiple episodes of pancreatitis, and may have suffered due to pancreatic damage, may develop type 3c or pancreatogenic diabetes.
“Patients with FCS who have experienced multiple episodes of pancreatitis, and may have suffered due to pancreatic damage, may develop type 3c or pancreatogenic diabetes.49”
From Familial chylomicronemia syndrome: Bringing to life dietary recommendations throughout the life span (2018) · cites this paper as [49]
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- Authors
- Rickels, M. R., Bellin, M., Toledo, F. G. S., Robertson, R. P., Andersen, D. K., Chari, S. T., Brand, R., Frulloni, L., Anderson, M. A., & Whitcomb, D. C.
- Affiliations
- University of Pennsylvania (US)
- University of Minnesota (US)
- University of Pittsburgh (US)
- Pacific Northwest Research Institute (US)
- National Institutes of Health (US)
- Mayo Clinic (US)
- University of Verona (IT)
- University of Michigan (US)
- Corresponding author
- Whitcomb, David C.
- ORCID
- Venue
- Pancreatology
- Publisher
- Elsevier BV
- Published
- 2013-07
- Volume
- 13
- Issue
- 4
- Pages
- 336-342
- ISSN
- 1424-3903 (ISSN-L)
- PMC
- PMC3830751
- OpenAlex
- W2073149519
- Cited by
- 249
- References
- 45
- Citations by year
- 2026: 16 · 2025: 11 · 2024: 8 · 2023: 14 · 2022: 14 · 2021: 28 · 2020: 23 · 2019: 22 · 2018: 29 · 2017: 28 · 2016: 20 · 2015: 21 · 2014: 12 · 2013: 3
- FWCI
- 19.71
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pancreatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R13DK096904, R13DK083216, R13DK09604, K23DK084315, R13DK088452, F32DK009604)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD052892)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- chronic pancreatitis, type 3c diabetes, impaired glucose tolerance, exocrine pancreatic insufficiency, beta-cell mass, total pancreatectomy with islet autotransplantation, HbA1c, fasting blood glucose, oral glucose tolerance test, diabetes management, medical nutrition therapy
- MeSH terms
- Diabetes Mellitus, Glucose Tolerance Test, Humans, Pancreas, Transplantation, Autologous, Islets of Langerhans Transplantation, Glucose Intolerance, Pancreatitis, Chronic
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