胰腺疾病继发糖尿病（3c 型）的患病率。

Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c).

机构信息

Third Medical Department and Policlinic, University Hospital Giessen and Marburg, Giessen Site, Klinikstrasse 33, Giessen, Germany.

出版信息

Diabetes Metab Res Rev. 2012 May;28(4):338-42. doi: 10.1002/dmrr.2260.

DOI:10.1002/dmrr.2260

PMID:22121010

Abstract

BACKGROUND

Diabetes mellitus secondary to pancreatic diseases is a condition seldom thought of in clinical practice. Yet, a high percentage of exocrine pancreatic insufficiency has been reported for the general population and especially for diabetic subjects. Thus, we investigated the prevalence of diabetes mellitus due to pancreatic diseases.

METHODS

In this study, we investigated 1868 patients diagnosed with diabetes mellitus who had been admitted to our hospital during the last 24 months. Patient data were diligently studied, and patients were reclassified according to the diabetes classification as proposed by the American Diabetes Association.

RESULTS

Among 1868 subjects, 172 patients could be classified as type 3c diabetes mellitus (9.2%). Among these were 135 diagnosed with chronic pancreatitis (78.5%), 12 with hereditary haemochromatosis, 14 with pancreatic cancer and 7 with cystic fibrosis. Thus, diabetes mellitus due to chronic pancreatitis occurred in this collective in 7.2% of all diabetic subjects. Misclassification of these patients was very common. Only 51.2% (88/172) were initially classified correctly. Most type 3 diabetes patients were initially misclassified as type 2 diabetes (69/84).

CONCLUSIONS

Diabetes mellitus secondary to pancreatic diseases (especially chronic pancreatitis) seems more common than generally believed with a prevalence of 9.2% among the subjects studied here. Because the awareness of this diabetes type is poor, misclassification is quite frequent. A common problem seems to be the differentiation between type 2 and type 3. Yet, the right classification of diabetes mellitus is important, because there are special therapeutic options and problems in patients with diabetes secondary to pancreatic diseases.

摘要

背景

继发于胰腺疾病的糖尿病在临床实践中很少被考虑。然而，大量的外分泌胰腺功能不全已在普通人群中报告，尤其是在糖尿病患者中。因此，我们调查了继发于胰腺疾病的糖尿病的患病率。

方法

在这项研究中，我们调查了过去 24 个月期间因糖尿病住院的 1868 名患者。我们仔细研究了患者的数据，并根据美国糖尿病协会提出的糖尿病分类重新对患者进行分类。

结果

在 1868 名患者中，有 172 名患者可归类为 3c 型糖尿病（9.2%）。其中，135 名患者被诊断为慢性胰腺炎（78.5%），12 名患者患有遗传性血色素沉着症，14 名患者患有胰腺癌，7 名患者患有囊性纤维化。因此，在这个人群中，慢性胰腺炎导致的糖尿病在所有糖尿病患者中占 7.2%。这些患者的分类错误非常常见。只有 51.2%（88/172）最初被正确分类。大多数 3 型糖尿病患者最初被错误地归类为 2 型糖尿病（69/84）。