Pancreatogenic diabetes mellitus: features of development, clinical course, diagnosis and treatment

Galina A. Batrak

For citation:

Abstract

The features of development, characteristic clinical symptoms, laboratory, instrumental methods of examination and the basic principles of therapy of pancreatogenic diabetes mellitus (DM) are determined. Correlations in the development and course of the disease were revealed. It has been proven that pancreatogenic diabetes occurs significantly more often in men, more than half of whom abuse alcohol and smoke, while after surgery for pancreatic necrosis, patients with pancreatogenic diabetes statistically significantly begin to drink less alcohol. According to a scientific study, the duration of pancreatogenic DM is closely interrelated with the duration of chronic pancreatitis. The low level of C-peptide confirms an early decrease in insulin secretion and, accordingly, the need for insulin therapy. Irregular intake of enzymes significantly contributes to exacerbations of chronic pancreatitis, worsens the course of diabetes and leads to the development of diabetic complications. It was noted that with the duration of pancreatogenic diabetes, the risk of hypoglycemia increases statistically significantly, which certainly requires regular blood glucose testing. Self-monitoring of blood glucose in patients with DM should be carried out with the help of modern, accurate and easy-to-use portable glucose meters, one of which is the Contour Plus Uan.

Key words: pancreatogenic diabetes mellitus, hypoglycemia, self-control of glycemia, glucometer Contour Plus Uan

References

1. Тарасова Ж.С., Бордин Д.С., Килейников Д.В., Кучерявый Ю.А. Панкреатогенный сахарный диабет: взгляд эндокринолога и гастроэнтеролога. Эффективная фармакотерапия. 2020; 16 (15): 92–100. [Tarasova ZH.S., Bordin D.S., Kilejnikov D.V., Kucheryavyj Yu.A. Pankreatogennyj saharnyj diabet: vzglyad endokrinologa i gastroenterologa. Effektivnaya farmakoterapiya. 2020; 16 (15): 92–100 (in Russian).]

2. Ребров А.П., Куницына М.А., Кашкина Е.И., Архангельская Е.Е. Панкреатогенный сахарный диабет: актуальные проблемы патогенеза и лечения (обзор). Саратовский научно-медицинский журнал. 2012; 8 (3): 862–7. [Rebrov A.P., Kunicyna M.A., Kashkina E.I., Arhangel'skaya E.E. Pankreatogennyj saharnyj diabet: aktual'nye problemy patogeneza i lecheniya (obzor). Saratovskij nauchno-medicinskij zhurnal. 2012; 8 (3): 862–7 (in Russian).]

3. Duggan SN, Ewald N, Kelleher L et al. The nutritional management of type 3c (pancreatogenic) diabetes in chronic pancreatitis. Eur J Clin Nutr 2017; 71 (1): 3–8. DOI: 10.1038/ejcn.2016.127

4. Berg T, Johansen L, Brekke IB. Insulin potentiates cholecystokinin (CCK)-induced secretion of pancreatic kallikrein. Acta Physiol Scand 1985; 123 (1): 89–95. DOI: 10.1111/j.1748- 1716. 1985. tb 07565.x

5. Sofranková A. Effect of exogenous and endogenous insulin on the secretory response of the pancreas to the octapeptide of cholecystokinin (CCK8) in normal rats. Physiol Bohemoslov 1984; 33 (5): 391–8.

6. Ewald N, Bretzel RG. Diabetes mellitus secondary to pancreatic diseases (Type 3c) – are we neglecting an important disease? Eur J Intern Med 2013; 24 (3): 203–6. DOI: 10.1016/j. ejim.2012.12.017

7. Czakó L, Hegyi P, Rakonczay Z Jr et al. Interactions between the endocrine and exocrine pancreas and their clinical relevance. Pancreatology 2009; 9 (4): 351–9. DOI: 10.1159/000181169

8. de-Madaria E, Abad-González A, Aparicio JR et al. The Spanish Pancreatic Club's recommendations for the diagnosis and treatment of chronic pancreatitis: part 2 (treatment). Pancreatology 2013; 13 (1): 18–28. DOI: 10.1016/j. pan.2012.11.310

9. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus. World Health Organization; 1999. URL: https://apps. who.int/iris/handle/10665/66040

10. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова. 9-й вып. Сахарный диабет. 2019; 22 (S1): 1–144. DOI: 10.14341/DM221S1 [Standards of specialized diabetes care. Edited by I.I. Dedov, M.V. Shestakova, A.Yu. Mayorov. 9th Edition. Diabetes mellitus. 2019; 22 (S1): 1–144. DOI: 10.14341/DM221S1 (in Russian).]

11. Губергриц Н.Б., Лукашевич Г.М., Голубова О.А. и др. Панкреатогенный сахарный диабет. Российский журнал гастроэнтерологии, гепатологии и колопроктологии. 2007; 17 (6): 11–6. [Gubergrits NB, Lukashevich GM, Golubova OA et al. Pancreatogenic diabetes mellitus. Russian Journal of Gastroenterology, Hepatology, Coloproctology 2007; 17 (6): 11–6 (in Russian).]

12. Ewald N, Kaufmann C, Raspe A et al. Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c). Diabetes Metab Res Rev 2012; 28 (4): 338–42. DOI: 10.1002/dmrr.2260

13. Hart PA, Bellin MD, Andersen DK et al; Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC). Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol 2016; 1 (3): 226–37. DOI: 10.1016/ S2468-1253(16)30106-6

14. Ewald N, Kaufmann C, Raspe A et al. Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c). Diabetes Metab Res Rev 2012; 28 (4): 338–42. DOI: 10.1002/dmrr.2260

15. Pan J, Xin L, Wang D et al. Risk Factors for diabetes mellitus in chronic pancreatitis: a cohort of 2011 patients. Medicine (Baltimore) 2016; 95 (14): e3251. DOI: 10.1097/MD.0000000000003251

16. Губергриц Н.Б., Беляева Н.В. Экзо- и эндокринная функции поджелудочной железы: один шаг от дуэта до дуэли. Сучасна гастроентерологiя. 2006; 30 (4): 18–30. [Gubergrits NB, Belyayeva NV. Exocrine and endocrine functions of the pancreas: one step from duet to duel. Modern Gastroenterology. 2006; 30 (4): 18–30 (in Russian).]

17. Watanabe S, Nagashio Y, Asaumi H et al. Pressure activates rat pancreatic stellate cells. Am J Physiol Gastrointest Liver Physiol 2004; 287 (6): G1175–81. DOI: 10.1152/ajpgi.00339.2004

18. Ewald N, Hardt PD. Diagnosis and treatment of diabetes mellitus in chronic pancreatitis. World J Gastroenterol 2013; 19 (42): 7276–81. DOI: 10.3748/wjg.v19.i42.7276

19. Czakó L, Hegyi P, Rakonczay Z Jr et al. Interactions between the endocrine and exocrine pancreas and their clinical relevance. Pancreatology 2009; 9 (4): 351–9. DOI: 10.1159/000181169

20. Батрак Г.А., Бродовская А.Н., Мясоедова С.Е. Роль самоконтроля гликемии в снижении риска развития диабетических микрои макроангиопатий. Consilium Medicum. 2019; 21 (12): 55–8. [Batrak G.A., Brodovskaya A.N., Myasoedova S.E. Rol' samokontrolya glikemii v snizhenii riska razvitiya diabeticheskih mikro- i makroangiopatij. Consilium Medicum. 2019; 21 (12): 55–8 (in Russian).]

21. ГОСТ Р ИСО 15197–2015 Тест-системы для диагностики in vitro. Требования к системам мониторинга глюкозы в крови для самоконтроля при лечении сахарного диабета. URL: http://docs. cntd.ru/document/1200120137 [GOST R ISO 15197–2015 In vitro diagnostic test systems. Requirements for blood glucose monitoring systems for self-testing in managing diabetes mellitus. URL: http://docs.cntd.ru/document/ 1200120137 (in Russian).]

For citation:Batrak G.A. Pancreatogenic diabetes mellitus: features of development, clinical course, diagnosis and treatment. Clinical review for general practice. 2023; 4 (4): 37–41. DOI: 10.47407/kr2023.4.4.00254

All accepted articles publish licensed under a Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

Clinical review for general practice