Appalachian Constellation: Type 3C Diabetes as the Link Between Diabetes and Chronic Pancreatitis

Abstract

Diabetes of the exocrine pancreas, also known as type 3c diabetes, is caused by a variety of underlying mechanisms, most commonly chronic pancreatitis. Type 3c diabetes leads to chronic inflammation of the pancreas and results in frequent episodes of hypo- or hyper-glycemia, and patients are commonly misdiagnosed as having type 2 diabetes. We report the case of a 52-year-old man from rural West Virginia (WV) who presented with a five-year history of chronic abdominal pain and recurrent pancreatitis. His physical examination, laboratory, and radiologic studies revealed an acute pancreatitis flare, and his elevated serum glucose level indicated new-onset diabetes, leading to a diagnosis of type 3c diabetes. Given the disproportionate rate of diabetes in WV, it is critical for healthcare providers to learn to recognize patients with diabetes with underlying pancreatic disease and to treat those patients appropriately.