Higher risk of death than in type 1 or 2 … “hidden diabetes” [건강한 가족]

When we think of “diabetes,” we often think of type 1 and type 2 diabetes. However, there is “hidden diabetes” which is not widely known around the world. This is pancreatic diabetes. Many patients are diagnosed with pancreatic disease before diabetes is diagnosed. Pancreatic diabetes mellitus is considered to be one of the most closely managed diabetes mellitus because it has a wider range of blood sugar fluctuations than type 1 and 2 diabetes, can lead to serious complications, and has a higher risk of death. Learn about the onset mechanism of pancreatic diabetes and how to deal with it.

Pancreatic diabetes mellitus differs from type 1 and type 2 diabetes in pathogenesis. Type 1 diabetes is an autoimmune disease that destroys beta cells in the pancreas, the “insulin-producing factory”. On the other hand, pancreatic diabetes mellitus occurs when there is disease in the pancreas or when more than 75% of the pancreas is removed by resection and the function of the pancreas itself decreases. The most common cause is chronic pancreatitis, and pancreatic ductal cell carcinoma, hemochromatosis, and a history of pancreatic surgery may also be. Professor Jeonghwan Park of the Department of Endocrinology and Metabolism at Hanyang University Hospital said: “According to some studies, the incidence of pancreatic diabetes represents 0.5% to 10% of all diabetic patients. there are many cases in which diabetes onset after the age of 50 is misdiagnosed as ‘adult diabetes’, ie type 2 diabetes “.

Pancreatic diabetes is called the most dangerous type of diabetes due to its fatal symptoms. Pancreatic diabetes mellitus is characterized by repeated fluctuations in hyperglycemia and hypoglycemia. This is caused by the destruction of all cells, including alpha cells, beta cells, and pancreatic polypeptide cells, in the pancreas due to pancreatic disease or pancreatic loss by resection. Professor Kiyoung Lee of the Department of Endocrinology and Metabolism at Gachon University Gil Hospital said: “In the original pancreas, when hypoglycemia occurs, alpha cells release glucagon into the blood to raise blood sugar and beta cells produce insulin to induce blood glucose. blood to absorb glucose. This is why people with diabetes mellitus experience sudden fluctuations in blood sugar levels. “When the causative disease of pancreatic diabetes is chronic alcoholic pancreatitis, diabetic neuropathy is also characteristic. This is because alcohol has damaged the nerves due to prolonged consumption.

In fact, a study in Korea showed in May that the clinical outcomes of pancreatic diabetes were worse than those of type 2 diabetes. According to “Diabetes Care”, a leading journal in the field of diabetes, the team of Professor Han Seung- jin at Ajou University Hospital’s Department of Endocrinology and Metabolism found 3629 patients with pancreatic diabetes diagnosed with diabetes after being diagnosed with pancreatic disease among 157,523 patients first diagnosed with diabetes between 2012 and 2017. Patients (2.3%) and 153,894 patients with type 2 diabetes were compared and analyzed. As a result, the rate of receiving insulin treatment 5 years after diagnosis was 38% higher in the diabetes group pancreatic disease compared to the type 2 diabetes group. As complications, hypoglycemia (85%), diabetic neuropathy (38%), nephropathy (38%) and ophthalmopathy (10%) were also more high. Mortality was also 74% higher. Professor Han Seung-jin, who led the study, pointed out: “If you are diagnosed with pancreatic disease such as chronic or acute pancreatitis or pancreatic cancer, you need to manage it to prevent the onset of pancreatic diabetes.

There are situations where you may suspect pancreatic diabetes. The first is when a healthy adult over the age of 50 has sudden, uncontrolled blood sugar levels and elevated blood sugar levels. Professor Cheon Young-guk of the Department of Gastroenterology at Konkuk University Hospital said: “In medicine, this is defined as underlined by new onset DM. In a study of a group of people over the age of 50 with recent diabetes development, pancreatic cancer was found in 3-5%, and a significant number of them also had advanced pancreatic cancer.

The second is when you have been receiving treatment for type 2 diabetes for a long time and have lost weight and have abdominal pain without knowing the cause. It is possible that the cause of the diabetes was pancreatic disease such as pancreatic cancer or that pancreatic cancer was induced in some patients with long-standing diabetes. Professor Cheon Young-guk said: “If you have diabetes, but suddenly your blood sugar is not controlled and symptoms such as weight loss occur, it is best to get tested for pancreatic cancer.” . ”

Pancreatic diabetes mellitus is caused by a lack of insulin secretion, so insulin injection treatment is usually done. At the same time, lifestyle changes are important. In order not to raise your blood sugar quickly, you should eat a balanced diet of mixed grains such as brown rice and vegetables rich in dietary fiber. In pancreatic diabetes mellitus, a high-fat, high-fat diet should be avoided because the polypeptide cells that break down and absorb nutrients in the pancreas break down, making it difficult to break down and absorb fat. In the case of patients with type 2 diabetes, when symptoms of hypoglycemia appear, as an emergency measure, eat monosaccharide foods such as candies, juices and yogurt to increase blood sugar. However, if a patient with pancreatic diabetes eats these foods during the hypoglycemic phase, the blood sugar rises rapidly and can move to the hyperglycemic phase. Eat a meal before exercise to prevent hypoglycemia, and if low blood sugar occurs, high-fat foods, such as ice cream, milk, and chocolate, raise blood sugar more slowly than candy, juice, or yogurt to prevent hyperglycemia as much as possible.

Jeong Simkyo ([email protected])