Diagnostics

Causes of pancreatic diabetes mellitus and what treatment is indicated?

In some patients, pancreatogenic diabetes mellitus develops against the background of pancreatic pathology. This type of diabetes does not belong to the first type (type 1 diabetes), nor to the second type (type 2). According to many experts, pancreatogenic diabetes is a DM of the third type, which has the characteristic features and characteristics of the course.

Development mechanism

The pancreas consists of exocrine and endocrine tissue. When pancreatitis occurs, diffuse destructive and degenerative changes in acinar tissue followed by atrophy of the acini, the main structural element of the exocrine gland.

Such changes can spread to the islets of Langerhans (structural units of the endocrine pancreas), whose function is the production of insulin. As a result, the endocrine apparatus of the pancreas is disrupted, which leads to the emergence of pancreatogenic diabetes mellitus.

Diabetes type 3 is characterized by some features:

  • Patients often have a normal physique;
  • No genetic predisposition;
  • Tendency to develop hypoglycemia;
  • Patients are often diagnosed with skin diseases;
  • Low need for insulin therapy;
  • Choleric temperament prevails in patients;
  • Late manifestation of symptoms (manifestation). Obvious signs of the disease are felt after 5-7 years from the onset of the underlying disease.

Macroangiopathy, microangiopathy and ketoacidosis are less common than with conventional diabetes.

Causes of

The main cause of the onset of type 3 diabetes is pancreatitis. But there are other factors that trigger the development of the disease.

These include:

  1. Injuries that violate the integrity of the pancreas;
  2. Surgical interventions (pancreatoduodenectomy, longitudinal pancreatojejunostomy, pancreathectomy,
  3. Pancreatic resection);
  4. Long-term drug treatment (use of corticosteroids);
  5. Other diseases of the pancreas, such as cancer, pancreatic necrosis, pancreatopathy;
  6. Cystic fibrosis;
  7. Hemochromatosis

Increase the likelihood of developing type 3 diabetes:

  • Obesity. Excess weight aggravates the course of pancreatitis and increases the risk of developing its complications. In patients with obesity, tissue resistance (insulin resistance) is more common, which increases the risk of developing diabetes.
  • Hyperlipidemia. Elevated levels of lipids in human blood interfere with blood circulation, as a result of which the pancreatic cells do not receive the required amount of nutrients and inflammation develops.
  • Alcoholism. With systemic use of alcohol, the rate of progression of exocrine gland insufficiency is much higher.

Symptomatology

Type 3 diabetes mellitus is characterized by late manifestation. The first symptoms can be seen only after the appearance of hyperinsulinism, which takes about 5-7 years to form.

Signs of pancreatic diabetes mellitus:

  • Constant feeling of hunger;
  • Polyuria;
  • Polydipsia;
  • Decreased muscle tone;
  • Weakness;
  • Cold sweat;
  • Shivering of the whole body;
  • Emotional arousal.

When pancreatic diabetes mellitus, the vascular walls become thinner, their permeability increases, which is externally manifested as bruises and edema.

In a chronic condition, seizures, fainting, memory impairment, disorientation in space, mental disorders may occur.

Treatment

Official medicine does not recognize type 3 diabetes, and in practice such a diagnosis is very rare. As a result, an incorrect treatment is prescribed, which does not give the desired effect.

The fact is that with pancreatic diabetes, unlike diabetes of the first two types, it is necessary to influence not only hyperglycemia, but also the underlying disease (pancreatic pathology).

Treatment for type 3 diabetes includes:

  1. Diet;
  2. Drug therapy;
  3. Insulin injection;
  4. Surgical intervention.

Diet

Diet for pancreatic diabetes mellitus is the correction of protein-energy deficiency, including hypovitaminosis. It is necessary to exclude fat, spicy and fried foods, simple carbohydrates (bread, butter products, sweets).

Consumed products must fully replenish the reserves of vitamins and minerals of the body. It is also necessary to completely give up alcohol.

Drug therapy

Drug therapy includes taking drugs:

  • Enzyme;
  • Sugar lowering;
  • Painkillers;
  • Providing restoration of electrolyte balance;
  • Vitamin complexes.

Enzyme therapy is an additional (adjuvant) method of treating a disease. Enzyme preparations used to treat type 3 diabetes should contain enzymes amylase, peptidase, and lipase in different ratios.

The purpose of these drugs is to improve the process of digestion and carbohydrate metabolism, thereby better controlling glucose levels, reducing the risk of complications, stabilizing glycohemoglobin levels and improving the patient's well-being.

One of the most frequently used enzyme preparations is CREON, which, in addition to its main purpose, also helps to stop pancreatic pain.

Sulfonylurea-based antidiabetic drugs are recommended for reducing sugar levels, since other antidiabetic drugs may not be effective.

Pancreatic pain can lead to the emergence of sitofobii (fear of eating), which only contribute to the development of hypoglycemia. To reduce pain, it is recommended to use non-narcotic analgesics.

Surgical intervention

This is an autotransplantation of the islets of Langerhans from a donor to a patient suffering from diabetes. After transplantation, the cells of the endocrine tissue begin to produce insulin, actively regulating glycemic indicators.

After such an operation, it is possible to perform a resection of the pancreas or pancreatomy.

Insulin injection

If necessary, the administration of insulin-containing drugs is prescribed, the dosage of which depends on the level of glucose in the blood, food products eaten, physical activity of the patient.

If the blood glucose indicators are within 4-4.5 mmol / l, then insulin injections are prohibited, since this can trigger a hypoglycemic crisis.

Watch the video: Patient Recovers from Pancreatitis (January 2020).

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