Underrecognized Form of Diabetes Linked to Worse Complications
Type 3c diabetes mellitus is frequently misdiagnosed and is associated with worse clinical outcomes, according to the findings of a recent study.
For their study, the researchers sought to determine the incidence of diabetes following pancreatic diseases, also known as type 3c diabetes, using primary care records from 31,789 patients with newly diagnosed adult-onset diabetes between January 1, 2005 and March 31, 2016. They compared the demographics, diabetes classification, glycemic control, and insulin use among patients with and without pancreatic diseases prior to a diabetes diagnosis. In addition, the researchers used regression analysis to control for potential baseline risk factors for poor glycemic control and the need for insulin.
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The researchers found that the incidence of type 3c diabetes was more common than type 1 diabetes, with 2.59 cases per 100,000 person-years compared with 1.64 cases per 100,000 person years. The majority of cases of diabetes following pancreatic diseases were classified by clinicians as type 2 diabetes (87.8%), while only 2.7% were classified as diabetes of the exocrine pancreas. Additionally, the median age of patients diagnosed with type 3c diabetes was 59 years and the median BMI was 29.2 kg/m2.
Compared with type 2 diabetes, diabetes following pancreatic disease was associated with poor glycemic control. Additionally, 20.9% of patients diagnosed with diabetes following acute pancreatitis and 45.8% of patients diagnosed with diabetes following chronic pancreatic disease used insulin within 5 years after diagnosis compared with 4.1% of those with type 2 diabetes.
“Diabetes of the exocrine pancreas is frequently labeled type 2 diabetes but has worse glycemic control and a markedly greater requirement for insulin,” the researchers concluded.
—Melissa Weiss
Reference:
Woodmansey C, McGovern AP, McCullough KA, et al. Incidence, demographics, and clinical characteristics of diabetes of the exocrine pancreas (Type 3c): a retrospective cohort study [published online October 23, 2017]. Diabetes Care. https://doi.org/10.2337/dc17-0542.