What measures should be taken to avoid misdiagnosis of type 3c diabetes?


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Type 3c diabetes or also called as pancreatic or pancreatogenic diabetes is caused due to damage to the pancreas that occurs due to inflammation, or surgery or cancer or diseases such as cystic fibrosis. A recent study in the UK has shown that this type is often being misdiagnosed as type 2. Since the treatment strategy is very different for these two types, it is critical that accurate diagnosis is made, and appropriate treatment is initiated. A few studies have shown that type 2 diabetes sometimes goes undetected and undiagnosed. Also, type 1 diabetes often gets detected too late or is misdiagnosed as type 2 diabetes in adults. Adding to this, there is another type of diabetes (type 3c) which is being misdiagnosed as type 2. A recent study published in Diabetes Care Journal states that majority of people with type 3c diabetes are misdiagnosed with type 2 which puts their short-term as well as long-term health at risk. Study design and results: A large-scale population screen involving about 2 million people was carried out and the researchers mainly looked for cases of diabetes occurring after conditions which had caused damage to the pancreas including pancreatitis, pancreatic cancer and tumors, and pancreatic surgery. They found that up to 97% percent of people who had the pancreatic disease at some point in life were diagnosed with type 2 diabetes instead of type 3c. The study also found that type 3c diabetes was more common than type 1 diabetes as 1% of new cases of diabetes in adults were type 1 and 1.6% were for type 3c. Another interesting finding of the study was that the onset of type 3c diabetes could occur long after the injury to the pancreas, in many cases more than a decade later. This long time gap may be one of the reasons that the two events are not often thought of as being linked, and hence the diagnosis of type 3c diabetes is being overlooked. Clinical implications: The researchers concluded that greater awareness of Type 3c diabetes within the medical profession is required immediately to improve management of this disease. The hormonal and metabolic aspects of type 3c diabetes are different than type 2 and hence several drugs used for type 2 diabetes may not be as effective in type 3c. Also, type 3c diabetes patients need to be put on insulin therapy straight away, and hence in such cases of misdiagnosis, there is a significant delay in starting the correct treatment.

Source: Chris Woodmansey, Andrew P. McGovern, Katherine A. McCullough, Martin B. Whyte, Neil M. Munro, Ana C. Correa, Piers A.C. Gatenby, Simon A. Jones, and Simon de Lusignan. Incidence, Demographics, and Clinical Characteristics of Diabetes of the Exocrine Pancreas (Type 3c): A Retrospective Cohort Study. Diabetes Care. 2017.