Diabetes secondary to chronic pancreatitis and pancreatic cancer: Observations from the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC)

Diabetes secondary to diseases of the exocrine pancreas, including chronic pancreatitis (CP) and pancreatic cancer (PDAC), is easily confused with type 2 diabetes (T2D). Misdiagnosis as T2D is common due to poor understanding of the underlying pathophysiology of these diabetes subtypes. In this review, we highlight contributions from our research group to further characterize the distinctions between CP-DM and PDAC-DM as it relates to postprandial response to pancreatic polypeptide (PP) and key metabolic alterations compared to T2D. In general, the PP response is blunted, and there is relatively lower insulin secretion, higher insulin sensitivity, and alpha cell dysregulation in CP-DM and PDAC when compared to T2D. Additionally, we provide updates regarding ongoing work to use clinical and genetic data to model the prediction of incident CP-DM. Lastly, we identify remaining knowledge gaps to further improve the diagnosis and treatment of type 3c diabetes.