Diabetes Mellitus Related to Diseases of the Exocrine Pancreas (Pancreatogenic Diabetes): Diagnosis and Treatment

Pancreatogenic diabetes mellitus (type 3c DM) refers to DM that develops secondary to diseases of the exocrine pancreas. This chapter describes the epidemiology and approach to diagnosis and treatment of pancreatogenic DM. Additionally, the accurate diagnosis of pancreatogenic DM caused by pancreatic cancer, i.e. pancreatic ductal adenocarcinoma (PDAC), is particularly critical as early diagnosis may provide an opportunity for early cancer detection. The prevalence and pathophysiology of pancreatogenic DM differs based on the underlying pancreatic disease. Diabetes mellitus occurs in the setting of a dysregulated metabolic state that eventually culminates in chronic systemic hyperglycemia. The primary deficiency in CP-DM is inadequate insulin secretion, so therapeutic decisions should be guided by this underlying pathophysiology.