Pancreatitis and Diabetes: What’s the Link?

Both pancreatitis and diabetes are conditions that affect the pancreas, an organ located behind the stomach. The pancreas produces many different enzymes and hormones. It has an exocrine function, where it produces digestive enzymes that help in digesting food. It also has an endocrine function to produce insulin and glucagon hormones, which the body needs to regulate blood sugar levels. Specialists in digestive and kidney diseases treat conditions affecting the pancreas. Please continue reading to find out the link between pancreatitis and diabetes.

What is diabetes?

Diabetes is a condition in which there is hyperglycemia (elevated blood sugar levels). According to the American Diabetes Association, more than 37 million Americans have diabetes. There are different types of diabetes based on the underlying cause of the rise in blood glucose levels.

Prediabetes

In this condition, blood sugar levels are higher than normal but not high enough to be called diabetes. Prediabetes progresses to diabetes without lifestyle modifications such as a healthy diet, exercise, and weight loss to achieve a healthy weight.

Insulin resistance

In people with insulin resistance, the cells in various tissues of the body don’t respond to the insulin hormone how they should, causing the pancreas to make more insulin.

Type 1 diabetes mellitus

In type 1 diabetes, the pancreas makes little to no insulin. This can cause a dangerous rise in blood sugar levels without treatment with diabetes medications. The underlying cause of type 1 diabetes is believed to be genetic. It is sometimes called juvenile-onset diabetes mellitus, secondary to the fact that it is usually diagnosed in children.

Type 2 diabetes mellitus

This is the most common type of diabetes mellitus, and it develops secondary to the pancreas not making enough insulin. This results in high blood glucose levels. Type 2 diabetes occurs due to environmental factors. It is also called adult-onset diabetes. Risk factors include an unhealthy diet, lack of exercise, and obesity.

Gestational diabetes

This type of diabetes is diagnosed during pregnancy and disappears after childbirth. Women who develop gestational diabetes are at a higher risk of developing diabetes later in life.

Type 3c diabetes

Also called cystic fibrosis-related diabetes, pancreatogenic diabetes, or secondary diabetes, type 3c diabetes develops when the pancreas is damaged and unable to make insulin. People at an increased risk of type 3c diabetes include those with medical conditions such as chronic pancreatitis and cystic fibrosis and those who have had pancreatic surgery (pancreatectomy or surgical removal of the pancreas).

What are the symptoms of diabetes?

Diabetes symptoms develop due to reduced endocrine pancreatic function. They include fatigue, increased thirst, increased hunger, frequent urination, blurred vision, unexplained weight loss, slow healing of wounds, numbness and tingling in the hands and feet, and frequent skin and vaginal yeast infections. The symptoms and clinical characteristics can vary depending on the disease severity.

Type 3c diabetes can cause additional symptoms due to pancreatic exocrine insufficiency (low levels of digestive enzymes that are made by the exocrine pancreas). These symptoms can include abdominal pain, bloating, gas, diarrhea, constipation, oily and foul-smelling stools, and unintended weight loss.

What is acute and chronic pancreatitis?

Pancreatitis is an inflammation of the pancreas. Risk factors for pancreatitis include obesity, smoking, alcohol consumption, diabetes, and a family history of pancreatitis. There are 2 main types of pancreatitis, one with a short and one with a long disease course.

Acute Pancreatitis

This is a short-lived condition that happens suddenly and goes away with treatment. Possible risk factors for developing pancreatitis include gallstones (this is called acute biliary pancreatitis), alcoholism, high calcium levels, high triglyceride levels (a type of cholesterol), certain medications, obesity, trauma, infections, abdominal surgery, cystic fibrosis, and pancreatic cancer. Severe acute pancreatitis can be life-threatening and requires emergency medical treatment. Some people develop recurrent acute pancreatitis with repeated attacks. Recurrent pancreatitis can progress to chronic pancreatitis.

Chronic Pancreatitis

Chronic pancreatitis is a long-lasting or chronic inflammation of the pancreas that gets worse over time, causing permanent damage. It can result in both endocrine and exocrine pancreatic insufficiency by interfering with the production of digestive juices and hormones.

What are the symptoms of pancreatitis?

Symptoms of acute pancreatitis include severe upper abdominal pain, pain that radiates to the back, tenderness, fever, fast heartbeat, nausea, and vomiting.

Symptoms of chronic pancreatitis include upper abdominal pain that may be aggravated after meals, unintentional weight loss, and steatorrhea (oily, smelly stools).

Can pancreatitis cause diabetes?

Yes, chronic pancreatitis, which causes long-term or chronic inflammation of the pancreas, can cause diabetes. It can lead to pancreatic dysfunction (inability of the pancreas to make enzymes and hormones). The inability to produce the insulin hormone can lead to diabetes. There is also some evidence that people who have had acute pancreatitis hospitalizations in the past are at an increased risk of developing diabetes.

Which type of diabetes is associated with pancreatitis?

Type 3c diabetes is associated with pancreatitis. Chronic pancreatitis is the underlying cause in up to 80% of people with type 3c diabetes.

How often does pancreatitis cause diabetes?

Researchers and medical professionals estimate that type 3c diabetes represents 5-10% of all diabetes cases in Western populations. However, the exact range is difficult to define because many patients with type 3c diabetes are misdiagnosed with type 2 diabetes which is the most common type of diabetes. Studies have shown that type 3c diabetes may be more common than type 1 diabetes.

Does diabetes cause pancreatitis?

There is no evidence that establishes a direct link between diabetes and pancreatitis. However, there are many associations between these two pancreatic diseases. Compared to healthy people, people with diabetes are at a higher risk of developing both acute and chronic pancreatitis.

Researchers believe that even though there is no direct causal relationship, many patients with diabetes go on to develop pancreatitis because the two conditions share similar risk factors. For example, high triglyceride levels, alcohol consumption, smoking, and certain medications can cause both diabetes and pancreatitis.

What’s the link between diabetes, pancreatitis, and pancreatic cancer?

There are well-established relationships between diabetes, chronic pancreatitis, and pancreatic cancer.

The link between diabetes and pancreatic cancer

The risk of pancreatic cancer is higher in people with new-onset diabetes mellitus. New-onset diabetes refers to hemoglobin A1c levels above 6.5% for the first three years after a diabetes diagnosis is made. After three years, the risk of pancreatic cancer falls to the same level as people with established diabetes.

It’s worth noting that in the vast majority of patients, new-onset diabetes does not mean there is underlying pancreatic cancer. Signs of pancreatic cancer in people with diabetes can include a rapid spike in blood glucose levels (more than seen with type 2 diabetes) and significant weight loss.

Also, pancreatic cancer can prevent the pancreas from making insulin. This reduced insulin production can cause you to develop diabetes type 3c.

The link between pancreatitis and pancreatic cancer

First-attack acute pancreatitis may be an early symptom of pancreatic cancer, especially in people diagnosed with new-onset diabetes mellitus. Chronic pancreatitis is a risk factor for developing pancreatic cancer, especially if there are other risk factors such as smoking and alcohol abuse. The risk of pancreatitis and pancreatic cancer may be genetic. Having a gene called PRSS1 gives a person an increased risk of both hereditary pancreatitis and pancreatic cancer.

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