Diabetes mellitus secondary to pancreatic diseases (Type 3c)--are we neglecting an important disease?

Eur J Intern Med. 2013 Apr;24(3):203-6. doi: 10.1016/j.ejim.2012.12.017. Epub 2013 Feb 1.


Type 3c diabetes mellitus (T3cDM) is a clinically relevant condition with a prevalence of 5-10% among all diabetic subjects in Western populations. Its prevalence and clinical importance have been underestimated and underappreciated so far. In contrast to the management of type 1 or type 2 diabetes, the endocrinopathy in T3cDM is very complex and complicated by additional present comorbidities such as maldigestion and concommitant qualitative malnutrition. The failure to correctly diagnose T3cDM leads to failure to implement an appropriate medical therapy of these patients. Physicians should screen for important and easily reversable pathological conditions such as exocrine insufficiency, lack of fat-soluble vitamins (especially vitamin D) and impairment of fat hydrolysis and incretin secretion which are found very commonly in T3cDM. Since most patients with T3cDM suffer from chronic pancreatitis, physicians must additionally be aware of the elevated risk of pancreatic cancer in this subset of patients.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus* / diagnosis
  • Diabetes Mellitus* / epidemiology
  • Diabetes Mellitus* / etiology
  • Diabetes Mellitus* / metabolism
  • Diabetes Mellitus* / physiopathology
  • Diagnostic Errors / prevention & control
  • Early Diagnosis
  • Humans
  • Incretins / metabolism
  • Malnutrition / etiology
  • Pancreas, Exocrine* / enzymology
  • Pancreas, Exocrine* / pathology
  • Pancreas, Exocrine* / physiopathology
  • Pancreatic Diseases / complications*
  • Pancreatic Diseases / diagnosis
  • Pancreatic Diseases / epidemiology
  • Pancreatic Diseases / metabolism
  • Pancreatic Diseases / physiopathology
  • Prevalence
  • Risk Factors
  • Vitamins / metabolism


  • Incretins
  • Vitamins