Introduction
Type 3 Diabetes groups together several pancreas disorders that all cause insulin deficiency. The insulin deficiency means that they behave like Type 1 Diabetes and require an intensive insulin regimen to control the glucose levels.
Included in this group are:
Similar to Type 1 Diabetes, the hyperglycaemia in these forms of diabetes can be challenging to manage and causes the same vascular complication profile.
Post-pancreatitis diabetes is the most common diagnosis in this group.
The widespread damage to the pancreas means that there are important differences between this diabetes and Type 1 Diabetes:
Cystic fibrosis-related diabetes presents in an interesting way. The insulin secretion is affected by the underlying pancreatic fibrosis in cystic fibrosis. While the basal insulin is usual normal, it’s the insulin response to food (1st phase and 2nd phase) that is delayed and attenuated. This means that the post-prandial glucose levels are high, while the fasting and pre-meal glucose levels are usually normal. Patients need to check their postprandial glucose levels (1 or 2-hour after eating) to see that there is something wrong. The HbA1c is deceivingly low due to the normal pre-meal glucose levels. Insulin treatment needs to focus on meal-related hyperglycemia eg. Apidra for meals.