Journal article
Approach to the Patient with Pancreatogenic Diabetes
The journal of clinical endocrinology and metabolism, Vol.111(2), pp.e569-e576
01/21/2026
DOI: 10.1210/clinem/dgaf623
PMCID: PMC12819855
PMID: 41252284
Appears in UI Libraries Support Open Access
Abstract
Diabetes can occur secondary to a wide array of exocrine pancreas pathologies. Pancreatogenic diabetes is a broad diagnostic term used to encompass these disparate causes of diabetes, which taken together are estimated to account for 1-9% of all cases of diabetes. The more common causes of pancreatogenic diabetes include pancreatitis, pancreatic ductal adenocarcinoma, cystic fibrosis, pancreatectomy, and fibrocalculous pancreatic disease. Persons with these exocrine pancreatic conditions should be screened for diabetes. Reciprocally, clinicians should consider the possibility of underlying pancreatic disease in persons with diabetes. Of special concern, diabetes can be the presenting sign of pancreatic ductal adenocarcinoma, for which clinical suspicion remains crucial as there are not yet distinguishing biomarkers. Timely diagnosis of diabetes is especially important in cystic fibrosis, because even mild diabetes can worsen lung disease and mortality risk in this condition. Exocrine pancreatic insufficiency is present in many cases of pancreatogenic diabetes. In these cases, provision of pancreatic enzyme replacement therapy may improve glycemic control. Optimal screening and treatment approaches are evolving, differing depending on the specific pancreatic pathology. Clinicians should be vigilant for exocrine pancreas symptomatology, including abdominal pain, steatorrhea, and malabsorption in their patients with diabetes.
Details
- Title: Subtitle
- Approach to the Patient with Pancreatogenic Diabetes
- Creators
- Katie Larson Ode - University of Iowa, Endocrinology and DiabetesYumi Imai - Iowa City VA Medical CenterAndrew W Norris - Iowa Diabetes and Endocrinology Research Center
- Resource Type
- Journal article
- Publication Details
- The journal of clinical endocrinology and metabolism, Vol.111(2), pp.e569-e576
- DOI
- 10.1210/clinem/dgaf623
- PMID
- 41252284
- PMCID
- PMC12819855
- NLM abbreviation
- J Clin Endocrinol Metab
- ISSN
- 0021-972X
- eISSN
- 1945-7197
- Publisher
- Oxford University Press
- Grant note
- Cystic Fibrosis Foundation: SUN22G0-CFRD National Institutes of Health: R01DK090490
Support for this work included the Cystic Fibrosis Foundation (A.W.N. SUN22G0-CFRD; K.L.O. STOLTZ4R0) and National Institutes of Health (Y.I. R01DK090490; K.L.O. P30DK054759).
- Language
- English
- Electronic publication date
- 11/18/2025
- Date published
- 01/21/2026
- Academic Unit
- Endocrinology and Diabetes; Stead Family Department of Pediatrics; Biochemistry and Molecular Biology; Endocrinology and Metabolism; Internal Medicine
- Record Identifier
- 9985033876502771
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