Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c)

Ewald, Nils; Kaufmann, C.; Raspe, A.; Hu, Kaiwen; Rg, Bretzel; Pd, Hardt

doi:10.1055/s-2007-972284

Cited by 27 publications

(41 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9). Furthermore, Ewald et al (2011) subsequently showed that nearly half of the T3cDM patients had been previously misdiagnosed as either T1DM (6%) or T2DM (40%). With the advent of improved imaging methods to detect pancreatic pathology, and the availability of a practical screening method to quantify exocrine pancreatic function, previous estimates of the prevalence of T3cDM are now understood to have been spuriously low (Ewald et al 2009).…”

Section: Prevalence Of T3cdmmentioning

confidence: 99%

Diabetes and pancreatic cancer

Cui¹,

Andersen²

2012

Endocrine-Related Cancer

131

102

View full text Add to dashboard Cite

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 relationship that requires more clinical attention. The risk of developing PC can be reduced by aggressive prevention and treatment of T2DM and obesity and the prompt diagnosis of T3cDM may allow detection of a tumor at a potentially curable stage.

show abstract

Section: Prevalence Of T3cdmmentioning

confidence: 99%

Diabetes and pancreatic cancer

Cui¹,

Andersen²

2012

Endocrine-Related Cancer

131

102

View full text Add to dashboard Cite

show abstract

“…[2][3][4][5] Smoking cessation is recommended (Evidence 3b, recommendation A). In chronic pancreatitis, however, smoking cessation will reduce the pain 16 Patient compliance regarding diet and intake of medication should be assured (recommendation A). It is generally recommended that a dietician should be involved (GCP/recommendation D).…”

Section: General Measurementsmentioning

confidence: 99%

Synopsis of recent guidelines on pancreatic exocrine insufficiency

Löhr

Oliver²,

Frulloni

2013

UEG Journal

View full text Add to dashboard Cite

Background: In recent years, three national gastroenterology societies established guidelines for the diagnosis and therapy of pancreatic exocrine insufficiency (PEI). In addition, the Cochrane Collaboration issued a review. Objective: The purpose of this paper is to present an overview of the recommendations and concordance between the four recent published guidelines and stimulate further discussion. Methods: A review of the Australian, German and Italian guidelines and the Cochrane review was conducted, and a synthesis was made of common statements.Results: There is a high degree of agreement on almost all items within these guidelines, both in the diagnosis of PEI and in terms of therapy and approach to management of PEI. In addition, novel emerging developments are highlighted, such as the fecal elastase-1 test, which is widely used but is not suitable for measuring mild-to-moderate PEI despite its ability to positively establish the diagnosis of severe PEI. One of the few novel tests proving to be useful is the 13 C mixed-chain triglycerides (MCT) breath test. This test, albeit an excellent quantitative test, is not widely used and is rarely available. The use of this test is making it apparent that there is a difference between treating the symptoms of PEI and treating malnutrition, the broader underlying defect. This may have direct consequences for the dosing of pancreatic enzymes (pancreatin), in that the consensus starting dose of all guidelines may be too low for some patients. Although chronic pancreatitis in adults and cystic fibrosis in children account for the main evidence base used for PEI, other indications are also discussed. Conclusions: There is good concordance between recommendations provided by international groups. More prospective studies are required in many areas, including the use of pancreatic enzymes in other gastrointestinal disorders, such as celiac disease and irritable bowel syndrome (IBS). We also need to assess the feasibility of the 13 C MCT breath test. At the same time, it needs to be confirmed that higher doses of pancreatic enzymes are really necessary to not only relieve the symptoms of PEI but also treat malnutrition appropriately.

show abstract

“…While its statistics were, until recently, largely confined to chronic pancreatitis and pancreatic cancer (3,4), emerging large scale population-based studies show that more than 60% of all cases of diabetes of the exocrine pancreas are due to new-onset diabetes after acute pancreatitis (NODAP) (5)(6)(7), and that the risk of NODAP may not depend on severity of acute pancreatitis (8,9). However, the molecular mechanisms underlying the pathophysiology of NODAP remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Calcitonin gene-related peptide: neuroendocrine communication between the pancreas, gut, and brain in regulation of blood glucose

et al. 2017

View full text Add to dashboard Cite

Background: Calcitonin gene-related peptide (CGRP), a ubiquitous neuropeptide, plays a diverse and intricate role in chronic low-grade inflammation, including conditions such as obesity, type 2 diabetes, and diabetes of the exocrine pancreas. Diabetes of exocrine pancreas is characterised by chronic hyperglycemia and is associated with persistent low-grade inflammation and altered secretion of certain pancreatic and gut hormones. While CGRP may regulate glucose homeostasis and the secretion of pancreatic and gut hormones, its role in chronic hyperglycemia after acute pancreatitis (CHAP) is not known. The aim of this study was to investigate the association between CGRP and CHAP.Methods: Fasting blood samples were collected to measure insulin, HbA1c, CGRP, amylin, C-peptide, glucagon, pancreatic polypeptide (PP), somatostatin, gastric inhibitory peptide, glicentin, glucagon-like peptide-1 and 2, and oxyntomodulin. Modified Poisson regression analysis and linear regression analyses were conducted. Five statistical models were used to adjust for demographic, metabolic, and pancreatitisrelated risk factors.Results: A total of 83 patients were recruited. CGRP was significantly associated with CHAP in all five models (P-trend <0.005). Further, it was significantly associated with oxyntomodulin (P<0.005) and glucagon (P<0.030). Oxyntomodulin and glucagon independently contributed 9.7% and 7%, respectively, to circulating CGRP variance. Other pancreatic and gut hormones were not significantly associated with CGRP.Conclusions: CGRP is involved in regulation of blood glucose in individuals after acute pancreatitis. This may have translational implications in prevention and treatment of diabetes of the exocrine pancreas.

show abstract

Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c)

Cited by 27 publications

References 0 publications

Diabetes and pancreatic cancer

Diabetes and pancreatic cancer

Synopsis of recent guidelines on pancreatic exocrine insufficiency

Calcitonin gene-related peptide: neuroendocrine communication between the pancreas, gut, and brain in regulation of blood glucose

Contact Info

Product

Resources

About