Type 3C diabetes (secondary diabetes)

On this page we explain what type 3c diabetes is, how it is diagnosed, its symptoms and treatment and management.

One of the functions of the pancreas is to produce hormones to keep blood glucose levels within a normal range (between 3.5-7 mmols/l). Insulin is one of these hormones and it is needed to allow the glucose (or sugar) in our blood, from the food we eat to enter our cells and fuel our bodies and provide us with energy.

What is type 3c diabetes?

Type 3c Diabetes (or Pancreatogenic Diabetes) can develop when the pancreas stops producing enough of the hormone called insulin. This can happen due to an illness or condition that affects or damages the pancreas. It can also occur if you have had surgery on your pancreas or if it is removed completely. When there isn’t enough insulin in the body the blood glucose levels begin to rise above the normal level and if left untreated this can lead to complications.

Approximately 9% of all diabetes cases are type 3c but the condition is under diagnosed. There is a lack of awareness amongst the general public and some health care professionals.

The main causes of type 3c diabetes are shown in the graph below. It is important to remember not everyone with chronic pancreatitis or the other conditions here will develop type 3c diabetes and the severity of the condition will depend on the damage caused to the pancreas. The amount of the pancreas removed during surgery and the health of any remaining organ.

Diagnosing type 3c diabetes

Diagnosis and management of type 3c diabetes can be challenging, partly due to lack of awareness of the condition. But remember, we know that type 3c is linked to problems with the pancreas. So, you can ask your doctor to check for type 3c if you’ve had pancreatic problems and can explain your reasons why.

Researchers have identified criteria for diagnosing type 3c diabetes including poor function of the pancreas, damage that is visible on imaging scans (such as CT) or removal of the pancreas. Diagnosis also requires the ruling out of other types of diabetes so doctors may look for autoimmune markers for type 1 diabetes using a blood test. Giving doctors a thorough medical history may help them to diagnose the condition.

People with type 3c diabetes often require insulin therapy with regular monitoring.

Symptoms of Type 3 Diabetes

 If you have Type 3c diabetes, then your pancreas may not be able to give you what you need to digest your food. This is called pancreatic exocrine insufficiency (PEI) and means that your pancreas isn’t working properly.

The signs to look out for can include:

  • losing weight without trying to
  • stomach pain
  • feeling more tired than usual
  • frequently passing wind
  • diarrhoea or fatty or oily stools

There are also common signs and symptoms of diabetes to look out for as well:

  • Feeling thirsty
  • Going to the toilet more often (urine)
  • Genital thrush or itching
  • Blurred vison

Treatment and management

Management of type 3c diabetes is partly dependent on the level of damage to the pancreas and the cause of the damage. Type 3c diabetes can be managed with insulin injections, or sometimes oral medications/tablets can be used.  If you require insulin injections your diabetes team will go through all the relevant information and education with you and you will receive regular check-ups.

It is also likely that your healthcare team will also discuss with you any dietary or lifestyle changes you might need to make, this may include treatment to help with digesting food.

Diabetes can be complicated, and it can cause different problems in the short term and the longer term but these are not inevitable. Diabetes related complications can include nerve, eye, foot and kidney damage, however keeping blood glucose levels, blood pressure and blood fat (lipids) levels under control will really help to reduce the risk of developing complications. This means going to your diabetes health checks and knowing how to look after yourself between appointments.

Management of type 3c diabetes also requires effectively treating the underlying pancreatic disease. In general, giving up smoking is important to prevent further damage to the pancreas. Cutting out alcohol also helps t maintain the health of the remaining pancreas and to prevent alcohol induced hypoglycaemia (low blood sugar).

Treating conditions that cause type 3c diabetes

One of the functions of the pancreas is to produce hormones. Insulin is one of these hormones and it is needed to allow the glucose (or sugar) in our blood, from the food we eat to enter our cells and fuel our bodies and provide us with energy. This means that blood glucose levels are maintained between 3.5 and 11 mmol/l

Type 3c Diabetes or Pancreatogenic Diabetes or secondary diabetes can develop when the pancreas stops producing enough of the hormone called insulin. This can happen following an illness or condition that affects or damages the pancreas. It can also occur if you have had surgery on your pancreas or if it is removed completely. When there isn’t enough insulin in the body the blood glucose levels begin to rise above the normal level and if left untreated this can lead to complications.

Approximately 9% of all diabetes cases are type 3c but the condition is under diagnosed. There is a lack of awareness amongst the general public and some health care professionals.

This from of diabetes occurs “secondary” to an event or issue which has affected the insulin-producing cells in the body. The main causes of type 3c diabetes are shown in the graph below. It is important to remember not everyone with chronic pancreatitis or the other conditions here will develop type 3c diabetes and the severity of the condition will depend on the damage caused to the pancreas. The amount of the pancreas removed during surgery and the health of any remaining organ.

Diagnosing type 3c diabetes

Diagnosis and management of type 3c diabetes can be challenging, partly due to lack of awareness of the condition. But remember, we know that type 3c is linked to problems with the pancreas. So, you can ask your doctor to check for type 3c if you’ve had pancreatic problems and can explain your reasons why.

Researchers have identified criteria for diagnosing type 3c diabetes including poor function of the pancreas, damage that is visible on imaging scans (such as CT) or removal of the pancreas. Diagnosis also requires the ruling out of other types of diabetes so doctors may look for autoimmune markers for type 1 diabetes using a blood test. Giving doctors a thorough medical history may help them to diagnose the condition.

People with type 3c diabetes often require insulin therapy

Symptoms of Type 3 Diabetes

 

If you have Type 3c diabetes, then your pancreas may not be able to give you what you need to digest your food. This is called pancreatic exocrine insufficiency (PEI) and means that your pancreas isn’t working properly.

The signs to look out for can include:

  • losing weight without trying to
  • stomach pain
  • feeling more tired than usual
  • frequently passing wind
  • diarrhoea or fatty or oily stools

There are also common signs and symptoms of diabetes to look out for as well:

  • Feeling thirsty
  • Passing urine more frequently
  • Genital thrush or itching
  • Blurred vison

Treatment and management

Management of type 3c diabetes is partly dependent on the level of damage to the pancreas and the cause of the damage. Type 3c diabetes may be managed with insulin injections, or sometimes tablets can be used.  If you require insulin injections your diabetes team will go through all the relevant information and education with you and you will receive regular check-ups.

It is also likely that your healthcare team will also discuss with you any dietary or lifestyle changes you might need to make, this may include treatment to help with digesting food.

Managing diabetes can be complicated, and it can cause different problems in the short term and the longer term but these are not inevitable. Diabetes related complications can include nerve, eye, foot and kidney damage, however keeping blood glucose levels, blood pressure and blood fat (lipids) levels under control will really help to reduce the risk of developing complications. This means going to your diabetes health checks and knowing how to look after yourself between appointments.

Management of type 3c diabetes also requires effectively treating the underlying pancreatic disease.

Treating conditions that cause type 3c diabetes

Many conditions affecting the pancreas can result in digestion issues and put people at risk of malnutrition and raised blood glucose levels after eating (mean induced hyperglycaemia). If the pancreas is damaged or not functioning properly, pancreatic enzyme replacement therapy (PERT) may be required to aid digestion. Good nutrition is required to help gain or maintain weight and to help keep blood sugars stable.

People with pancreatic cancer can find it difficult to eat, digest their good maintain their weight. This may make managing blood sugars more difficult. The goal if treating type 3c diabetes in someone with pancreatic cancer is to prevent very high and very low blood glucose levels, stop any further weight loss and avoid acute complications of diabetes. Not sure if prevention of long term complications would be relevant?

Advice for patients with type 3c diabetes

  • Eat meals little and often in a regular pattern (at similar times every day) and include starchy carbohydrates such potatoes, bread, rice or pasta
  • Try not to skip meals
  • You may be advised to test blood glucose levels. Your healthcare team will show you how to do this and advise you when to test.
  • Consider a diary to record insulin, pancreatic enzymes, exercise and food intake
  • Ask for a dietitian referral.

Symptoms to be concerned about

People with type 3c diabetes may experience high or low blood glucose levels.

Low blood glucose is known as a “hypo”

A hypo is when the blood glucose level drops below 4mmol/l, this can happen if you take insulin or certain tablets for diabetes. It is very important to try to avoid hypos as damage to the pancreas can reduce the normal response to low blood glucose levels. If one does occur, treatment must be given immediately.

Common Symptoms of hypoglycaemia include;

  • trembling and feeling shaky
  • sweating
  • being anxious or irritable
  • becoming pale
  • palpitations and a fast pulse
  • lips feeling tingly
  • blurred sight
  • being hungry
  • feeling tearful
  • sudden tiredness
  • having a headache
  • lack of concentration

A hypo requires immediate treatment with one of the following15-20g fast acting carbohydrate:

  • 5-6 dextrose tablets
  • 150ml sugary drink (non-diet) drink
  • 200ml pure fruit juice
  • 5 jelly babies
  • 60ml GlucoJuice

To stop your sugar levels going down again it is important to eat a snack or meal containing slower-acting carbohydrate.

This could be a:

  • sandwich
  • piece of fruit
  • bowl of cereal
  • glass of milk.
  • Or it could be your next meal, if it’s due.

Hypo’s that are not resolving after treatment require urgent medical attention

If you test your blood glucose levels you should test your blood glucose more frequently after a hypo. Let your health professional team know that is has occurred as you may need a treatment change.

Regular glucose monitoring, especially with any of these symptoms is required to identify and then treat hypoglycaemia. Low blood sugars that are not responding to treatment require urgent medical attention.

What is type 3c diabetes?

One of the functions of the pancreas is to produce hormones to keep blood glucose levels within a normal range of between 3.5-7 mmols/l. Insulin is one of these hormones and it is needed to allow the glucose (or sugar) in our blood, from the food we eat to enter our cells and fuel our bodies and provide us with energy.

Type 3c Diabetes or Pancreatogenic Diabetes can develop when the pancreas stops producing enough of the hormone called insulin. This can happen due to an illness or condition that affects or damages the pancreas. It can also occur if you have had surgery on your pancreas or if it is removed completely. When there isn’t enough insulin in the body the blood glucose levels begin to rise above the normal level and if left untreated this can lead to complications.

Approximately 9% of all diabetes cases are type 3c but the condition is under diagnosed. There is a lack of awareness amongst the general public and some health care professionals.

The main causes of type 3c diabetes are shown in the graph below. It is important to remember not everyone with chronic pancreatitis or the other conditions here will develop type 3c diabetes and the severity of the condition will depend on the damage caused to the pancreas. The amount of the pancreas removed during surgery and the health of any remaining organ.

Diagnosing type 3c diabetes

Diagnosis and management of type 3c diabetes can be challenging, partly due to lack of awareness of the condition. But remember, we know that type 3c is linked to problems with the pancreas. So, you can ask your doctor to check for type 3c if you’ve had pancreatic problems and can explain your reasons why.

Researchers have identified criteria for diagnosing type 3c diabetes including poor function of the pancreas, damage that is visible on imaging scans (such as CT) or removal of the pancreas. Diagnosis also requires the ruling out of other types of diabetes so doctors may look for autoimmune markers for type 1 diabetes using a blood test. Giving doctors a thorough medical history may help them to diagnose the condition.

People with type 3c diabetes often require insulin therapy with regular monitoring.

Symptoms of Type 3 Diabetes

 

If you have Type 3c diabetes, then your pancreas may not be able to give you what you need to digest your food. This is called pancreatic exocrine insufficiency (PEI) and means that your pancreas isn’t working properly.

The signs to look out for can include:

  • losing weight without trying to
  • stomach pain
  • feeling more tired than usual
  • frequently passing wind
  • diarrhoea or fatty or oily stools

There are also common signs and symptoms of diabetes to look out for as well:

  • Feeling thirsty
  • Going to the toilet more often (urine)
  • Genital thrush or itching
  • Blurred vison

Treatment and management

Management of type 3c diabetes is partly dependent on the level of damage to the pancreas and the cause of the damage. Type 3c diabetes can be managed with insulin injections, or sometimes oral medications/tablets can be used.  If you require insulin injections your diabetes team will go through all the relevant information and education with you and you will receive regular check-ups.

It is also likely that your healthcare team will also discuss with you any dietary or lifestyle changes you might need to make, this may include treatment to help with digesting food.

Diabetes can be complicated, and it can cause different problems in the short term and the longer term but these are not inevitable. Diabetes related complications can include nerve, eye, foot and kidney damage, however keeping blood glucose levels, blood pressure and blood fat (lipids) levels under control will really help to reduce the risk of developing complications. This means going to your diabetes health checks and knowing how to look after yourself between appointments.

Management of type 3c diabetes also requires effectively treating the underlying pancreatic disease. In general, giving up smoking is important to prevent further damage to the pancreas. Cutting out alcohol also helps t maintain the health of the remaining pancreas and to prevent alcohol induced hypoglycaemia (low blood sugar).

Treating conditions that cause type 3c diabetes

Many conditions affecting the pancreas can result in digestion issues and put people at risk of malnutrition and raised blood glucose levels after eating (mean induced hyperglycaemia). If the pancreas is damaged or not functioning properly, pancreatic enzyme replacement therapy (PERT) may be required to aid digestion. Good nutrition is required to help gain or maintain weight and to help keep blood sugars stable.

People with pancreatic cancer can find it difficult to eat, digest their good maintain their weight. This may make managing blood sugars more difficult. The goal if treating type 3c diabetes in someone with pancreatic cancer are to prevent very high and very low blood glucose levels, stop any further weight loss and avoid longer term complications of diabetes.

Advice for patients with type 3c diabetes

  • Eat meals little and often in a regular pattern (at similar times every day) and include starchy carbohydrates such potatoes, bread, rice or pasta
  • Try not to skip means
  • Measure glucose levels as directed by your healthcare team
  • Ensure that pancreatic enzyme replacement therapy is effective if required
  • Consider a diary to record insulin, pancreatic enzymes, exercise and food intake
  • Ask for a dietitian referral

Symptoms to be concerned about

People with type 3c diabetes may suffer from high or low blood sugars. It is important to be aware of the symptoms of very low blood sugar (hypoglycaemia or hypo) as this needs immediate management with high sugar foods or drinks and can be dangerous.

A hypo is when the blood glucose level drops below 4mmol/l, this can happen if you take insulin or certain tablets for diabetes.

Common Symptoms of hypoglycaemia include;

  • trembling and feeling shaky
  • sweating
  • being anxious or irritable
  • becoming pale
  • palpitations and a fast pulse
  • lips feeling tingly
  • blurred sight
  • being hungry
  • feeling tearful
  • tiredness
  • having a headache
  • lack of concentration

A hypo requires immediate treatment with one of the following15-20g fast acting carbohydrate:

  • 5-6 dextrose tablets
  • 150ml sugary drink (non-diet) drink
  • 200ml pure fruit juice
  • 5 jelly babies
  • 60ml GlucoJuice

After a hypo, you will need to eat or drink a bit more. This is to stop your sugar levels going down again. Try to eat some slower-acting carbohydrate.

This could be a:

  • sandwich
  • piece of fruit
  • bowl of cereal
  • glass of milk.
  • Or it could be your next meal, if it’s due.

Regular glucose monitoring, especially with any of these symptoms is required to identify and then treat hypoglycaemia. Low blood sugars that are not responding to treatment require urgent medical attention.