pancreatogenic

Pancreatogenic is an adjective meaning arising from or caused by the pancreas. In medical use it is commonly applied to diabetes that results from pancreatic disease, referred to as pancreatogenic diabetes or Type 3c diabetes mellitus (T3cDM). The term underscores a pathophysiology distinct from autoimmune or age-related forms of diabetes.

Causes include chronic pancreatitis, pancreatic cancer, surgical removal or resection of pancreatic tissue, cystic fibrosis, autoimmune pancreatitis, and other forms of pancreatic injury. The underlying process typically involves combined loss or dysfunction of pancreatic exocrine tissue and endocrine islet cells, leading to impaired insulin secretion and sometimes diminished glucagon production, with concomitant malabsorption and marked glycemic variability.

Diagnosis relies on clinical context and exclusion of other diabetes categories. A known pancreatic disorder is supportive; evaluation may show reduced C-peptide, evidence of exocrine pancreatic insufficiency, and imaging-confirmed pancreatic disease. Autoantibody testing helps differentiate from type 1 diabetes; the phenotype may resemble type 2 diabetes early on but often includes poor glycemic control with variable insulin needs. Distinguishing pancreatogenic diabetes from other forms is important for management.

Management emphasizes treatment of the pancreatic disease and tailored glycemic control. Pancreatic enzyme replacement therapy addresses malabsorption; nutritional support is common. Glycemic treatment frequently requires insulin therapy; metformin or other agents may be used selectively, but beta-cell loss and glucagon deficiency raise hypoglycemia risk, necessitating careful monitoring. Some guidelines advocate recognizing Type 3c diabetes as a distinct category.