A considerable proportion (5–10%) of all diabetes cases are actually caused by diseases of the pan- creas and are classiﬁed as type 3c diabetes mellitus. The most common disease leading to diabetes is chronic pancreatitis. Adequate pancreatic enzyme replacement therapy can enhance secretion of incretins which leads to improved insulin release. Diabetes can also be a sign of occult pancreas malignancy and is often ameliorated by treating the tumor. Nowadays, hemochromatosis is dia- gnosed and treated in early stages; thus, the classic triad of skin pigmentation, liver disease, and bronze diabetes can generally be prevented. Because survival of patients with cystic ﬁbrosis has greatly improved, complications like diabetes mellitus must be treated more oeft n. The utilization of a high calorie diet in cystic ﬁbrosis complicates diabetes treatment. Keywords Glucose intolerance · Pancreatitis · Exocrine pancreatic insuﬃciency · Cystic ﬁbrosis · Hemo- chromatosis Der Diabetologe CME Tab. 1 Deﬁnition des Diabetes mellitus Typ 3c nach Ewald u. Bretzel  Hauptkriterien (alle Exokrine Pankreasinsuﬃzienz (nachgewiesen mittels Stuhltest auf Elastase-1 müssen vorhanden sein) oder eines direkten Funktionstests) Pathologische Bildgebung des Pankreas (Endosonographie, MRT, CT) Fehlen von Markern für einen Typ-1-Diabetes Nebenkriterien Gestörte Betazellfunktion (nachgewiesen anhand z.B. HOMA-B, C-Peptid-Gluko- se-Quotient) Keine stark
Der Diabetologe – Springer Journals
Published: May 29, 2018
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