• Zhuravlyova L. V. Kharkiv National Medical University, Kharkiv, Ukraine
  • Zhuravlyova A. K. Kharkiv National Medical University, Kharkiv, Ukraine



pancreatogenic diabetes, type 3c diabetes, chronic pancreatitis, exocrine insufficiency of pancreas


This article is a review of current literature covering issues of terminology, classification, prevalence, pathogenesis, clinical manifestations, diagnosis and treatment of diabetes associated with diseases of the exocrine
pancreas. It has been established that the prevalence of type 3c diabetes is much higher than the recorded incidence, which is associated with the difficulties of diagnosis and the absence of specific criteria for making this
diagnosis. The most common cause of diabetes type 3c is chronic pancreatitis. The main defect is insufficient
insulin secretion along with the development of hepatic resistance to it, as well as insufficient postprandial glucose-dependent stimulation of insulin secretion due to a decrease in incretin production. Usually there is compensatory increase in peripheral insulin sensitivity, which can lead to severe cases of hypoglycemia, especially
on the background of insulin therapy, and causes a «brittle» course of this type of diabetes. However, peripheral
insulin resistance may also occur. Clinical manifestations are associated with exocrine insufficiency of pancreas, and are characterized by the presence of malabsorption and malnutrition, an increased risk of osteoporosis
and bone fractures. Currently, there are no guidelines for management of type 3c diabetes, and the main goal is
to achieve HbA1c < 7 % to minimize the risk of complications, as in type 1 and 2 diabetes. Mild hyperglycemia
can be adjusted by taking oral glucose-lowering drugs, severe patients and patients with very low body weight
should receive insulin replacement therapy. Also, the choice of glucose-lowering therapy depends on the primary
disease of the pancreas that caused diabetes


Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2003; 26(1): S5-S20.

American Diabetes Association. Diabetes Care 2002; 25: 213-229.

American Diabetes Association. Diabetes Care 2018; 41(1): S13-S27.

Petrov MS. Pancreatology 2017; 17(4): 523-526.

Hardt PD, Brendel MD, Kloer HU, Bretzel RG. Diabetes Care 2008; 31(2): S165-S169.

Rickels MR, Bellin M, Toledo FGS, et al. Pancreatology 2013; 13(4): 336-342.

Ewald N, Kaufmann C, Raspe A, et al. Diab Metab Res Rev 2012; 28(4): 338-342.

Cui Y, Andersen DK. Pancreatology 2011; 11: 279-294.

Helm JF, Centeno BA, Coppola D, et al. Cancer Control 2008;15: 288-294.

Moran A, Becker D, Casella SJ, et al. Diab Care 2010; 33: 2677-2683.

Duggan ND, Conlon KC. Pract Gastroenterol 2017; 163: 14-23.

Muggeo M, Moghetti P, Faronato PP, et al. J Endocrinol Invest 1987; 10(3): 311-319.

Yki-Jдrvinen H, Kiviluoto T, Taskinen MR. Metabolism 1986; 35(8): 718-727.

Brunicardi FC, Chaiken RL, Ryan AS, et al. J Clin Endocrinol Metab 1996; 81(10): 3566-3572.

Rabiee A, Galiatsatos P, Salas-Carrillo R, et al. J Diabetes Sci Technol 2011;5(6): 1521-1528.

Andersson AK, Flodstrom M, Sandler S. Biochem Biophys Res Commun 2001;281: 396-403.

Boni-Schnetzler M, Boller S, Debray S, et al. Endocrinology 2009;150: 5218-5229.

Leung L, Radulovich N, Zhu CQ, et al. PLoS One 2012; 7: e46677.

Ewald N, Bretzel RG. Eur J Intern Med 2013; 24: 203-206.

Hart PA, Bellin MD, Andersen DK, et al. Lancet Gastroenterol Hepatol 2016; 1(3): 226-237.

Mann ST, Mann V, Stracke H, et al. Eur J Med Res 2008; 13: 68-72.

Duell EJ, Lucenteforte E, Olson SH, et al. Ann Oncol 2012; 23: 2964-2970.

Magruder JT, Elahi D, Andersen DK. Pancreas 2011; 40: 339-351.

Gubergric NB, Lukashevich GM, Golubova OA, et al. RZhGGK 2006; 6: 11-16.

Makuc J. Diabetes Metab Syndr Obes 2016; 9: 311-315.

Moran A, Brunzell C, Cohen RC, et al. Diabetes Care 2010; 33(12): 2697-2708.

Sadeghi N, Abbruzzese JL, Yeung SC, et al. Clin Cancer Res 2012; 18: 2905-2912.

Cefalu WT, Riddle MC. Diabetes Care 2015; 38(3): 352-354.

Banerjee A, Onyuksel H. Nanomedicine 2013; 9(6): 722-728.




How to Cite

Журавльова , Л. В., & Журавлева, А. К. (2019). CURRENT IDE A OF PANCREATOGENIC DIABETES. Problems of Endocrine Pathology, 68(2), 104-111.