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Pancreatogenic Diabetes (Type 3c) — RACP Adult Medicine MCQ

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ModerateEndocrinologyPancreatogenic Diabetes (Type 3c)RACP Adult Medicine

A 55-year-old man with chronic pancreatitis develops diabetes requiring insulin. His HbA1c is 69 mmol/mol on basal insulin alone. He has episodes of hypoglycaemia. His BMI is 22 kg/m². What characterises his diabetes?

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Correct answer: C — Insulin therapy alone

Pancreatogenic diabetes (type 3c) results from destruction of both exocrine and endocrine pancreatic tissue. It is characterised by loss of both insulin and glucagon production, making patients brittle (episodes of both hyper- and hypoglycaemia). Insulin therapy is required. Metformin can be used if tolerated. Hypoglycaemia is particularly dangerous due to absent glucagon counter-regulation.

Reference: ADS – 2024 – Type 3c Diabetes; GESA 2024