The spectrum of diabetes in acute and chronic pancreatitis

糖尿病 医学 急性胰腺炎 胰腺炎 内科学 胃肠病学 重症监护医学 内分泌学
作者
Søren Schou Olesen,Frederico G. S. Toledo,Phil A. Hart
出处
期刊:Current Opinion in Gastroenterology [Lippincott Williams & Wilkins]
卷期号:38 (5): 509-515 被引量:11
标识
DOI:10.1097/mog.0000000000000864
摘要

PURPOSE OF REVIEW: To discuss the spectrum of diabetes related to acute and chronic pancreatitis (which are types of pancreatogenic diabetes) and its overlapping features with type 1 and type 2 diabetes. RECENT FINDINGS: Patients with diabetes related to acute and chronic pancreatitis present clinically within a spectrum of overlapping features with other forms of diabetes. In this spectrum, glucose metabolism alterations range from increased insulin resistance following acute pancreatitis (resembling type 2 diabetes) towards a permanent loss of beta-cell function and impaired insulin secretion in end-stage chronic pancreatitis. Overlapping features with type 1 diabetes (beta cell autoantibodies) and type 2 diabetes (obesity, dyslipidemia, and hereditary/genetic factors) contribute to the heterogeneity of this spectrum. SUMMARY: Pancreatogenic diabetes secondary to acute or chronic pancreatitis is a heterogeneous entity with a variable clinical presentation, including many cases that are misdiagnosed and treated as type 2 diabetes. This is problematic as pancreatogenic diabetes is associated with a poor prognosis and entails special considerations for management. Recent discoveries showing overlapping features with type 1 and type 2 diabetes along with an improved understanding of its pathophysiology are expected to improve the diagnosis and treatment of these and other forms of pancreatogenic diabetes.
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