Type 3c Diabetes — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateEndocrinology & DiabetesType 3c DiabetesRACP Adult Medicine

A 58-year-old man with a history of heavy alcohol use and chronic pancreatitis presents with new-onset diabetes, steatorrhoea, and weight loss. His HbA1c is 77 mmol/mol. CT shows a shrunken, calcified pancreas. What type of diabetes does he have?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Pancreatogenic diabetes (Type 3c)

Pancreatogenic (type 3c) diabetes results from chronic pancreatic disease (chronic pancreatitis, pancreatic surgery, cystic fibrosis, haemochromatosis) causing destruction of both exocrine and endocrine pancreatic tissue. It differs from T1DM and T2DM in its pathophysiology. Patients lose both beta cells (insulin) AND alpha cells (glucagon), making them particularly prone to hypoglycaemia with insulin therapy. PERT for exocrine insufficiency is also required. Metformin is first-line; insulin is often needed.

Reference: eTG – 2025 – Endocrinology; ADS – 2024 – Type 3c Diabetes Management