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Diabetes associated with pancreatic diseases

Meier, Juris J.; Giese, Arnd

Current Opinion in Gastroenterology: September 2015 - Volume 31 - Issue 5 - p 400–406
doi: 10.1097/MOG.0000000000000199
PANCREAS: Edited by Fred Gorelick
Editor's Choice

Purpose of review: A relevant number of patients with pancreatic disorders suffer from secondary diabetes. Recent data have shed light on the link between pancreatic damage and subsequent impairments in glucose homeostasis. Furthermore, epidemiological studies provided insights into the relationship between diabetes and the risk of pancreatic carcinoma or pancreatitis. Pancreaticogenic diabetes requires a tailored therapeutic approach taking into account the individual properties of the available glucose-lowering drugs.

Recent findings: We review the available literature concerning diabetes in patients with acute or chronic pancreatitis or pancreatic carcinoma. The relationship between the pancreatic damage and alterations in insulin and glucose homeostasis is summarized as well as the effect of diabetes mellitus on the risk of pancreatic cancer and pancreatitis. Caveats in the treatment of pancreaticogenic diabetes with currently available drugs are being discussed.

Summary: Patients with pancreatic diseases should be screened for diabetes by means of an oral glucose tolerance test. There is a close inverse relationship between pancreatic β-cell loss and postchallenge hyperglycemia. The risk of hypoglycemia may be increased in patients with pancreaticogenic diabetes. Newly diagnosed diabetes may be a harbinger of pancreatic cancer. There is increasing evidence suggesting an increased risk for (pancreatic) cancer and pancreatitis in patients with diabetes mellitus. Further studies on the ideal glucose-lowering treatment of patients with pancreaticogenic diabetes will be required.

Division of Diabetology and Gastrointestinal Endocrinology, St. Josef-Hospital Bochum, Ruhr-University Bochum, Bochum, Germany

Correspondence to Juris J. Meier, Division of Diabetology and Gastrointestinal Endocrinology, St. Josef-Hospital Bochum, Ruhr-University Bochum, Gudrunstraße 56, Bochum 44791, Germany. Tel: +49 234509 2711; fax: +49 234 509 2713; e-mail: juris.meier@rub.de

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