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Ein relevanter Anteil (5–10 %) aller Diabetesfälle wird durch Pankreaserkrankungen verursacht, diese werden als Diabetes mellitus Typ 3c klassifiziert. Die häufigste Erkrankung hierbei ist die chronische Pankreatitis. Durch oralen Pankreasenzymersatz können die Bildung von Inkretinen und dadurch die Insulinsekretion verbessert werden. Ein Diabetes kann auch Zeichen eines Pankreaskarzinoms sein und ist oft nach einer Therapie des Tumors reversibel. Die Hämochromatose wird heutzutage früher diagnostiziert. Durch adäquate Behandlung mittels Phlebotomie sind die klassischen Symptome und damit der sog. Bronzediabetes inzwischen eine Seltenheit. Patienten mit zystischer Fibrose erreichen ein immer höheres Lebensalter, sodass auch deren Organkomplikationen häufiger behandelt werden müssen. Der Diabetes spielt hierbei eine besondere Rolle, da er den Ernährungsstatus entscheidend beeinflusst und damit auch die Mortalität. Die notwendige hochkalorische Diät verkompliziert die Diabetestherapie.
Der Diabetologe – Springer Journals
Published: May 29, 2018
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