The Diabetes You Haven't Heard of: Type 3c Diabetes

You’ve probably heard of Type 1 and Type 2 diabetes, but did you know there are others in the mix? Type 3c diabetes is not a new diagnosis, but the name is relatively new out of the research realm. So, why is type 3c different? Dave Trachtenbarg, MD, UnityPoint Health, explains Type 3c diabetes, how treatments are similar and different, plus symptoms that might point to this particular disease.

What is Type 3c Diabetes?

Dr. Trachtenbarg says your pancreas has two main functions:

• Control blood sugar. The pancreas produces insulin and other hormones to control blood sugar.
• Aids in food digestion. The pancreas creates enzymes to help digest food for your body.

“With Type 1 and Type 2 diabetes, the pancreas doesn’t produce enough insulin to control the blood sugar, but food digestion is normal,” Dr. Trachtenbarg says. “With Type 3c diabetes food digestion is also affected. Symptoms could include bloating and chronic diarrhea.”

Type 3c diabetes is also sometimes referred to as pancreatogenic or pancreatogenous diabetes mellitus. Dr. Trachtenbarg cites research that shows the average age of diagnosis is 59, and about 60 percent of patients diagnosed with type 3c diabetes are men.

What Causes Type 3c Diabetes?

Dr. Trachtenbarg identifies some of the main causes of Type 3c diabetes, some of which are genetic and others that are not.

• Pancreatitis. About 80 percent of the time, complications of chronic inflammation of the pancreas is the cause of Type 3c. Pancreatitis is caused by numerous things, including gallstones, excessive alcohol use, medications and high triglycerides (one of the fats in the blood related to cholesterol).
• Pancreas Removal. Type 3c is also caused when the pancreas is removed by surgery due to cancer or trauma.
• Cystic Fibrosis. This is one of many genetic causes of Type 3c. Cystic Fibrosis affects the secretion in the lungs early in the disease and affects the pancreas in older patients.
• Hemochromatosis. This occurs from excessive iron, which damages the pancreas.

How do Doctors Test and Treat Type 3c Diabetes?

“Tests of the stool that show undigested food are used to help diagnose Type 3c diabetes. One test is looking at the stool for undigested fat. A special stool test called monoclonal fecal elastase-1 can also be used. Finally, radiology tests like an ultrasound, CT or MRI may also be used to inspect for damage to the pancreas,” Dr. Trachtenbarg says.

Then, once you’re diagnosed with Type 3c diabetes, the treatment begins. The severity of the disease will determine the treatment course.

• Mild Disease. It’s most often treated like Type 2 diabetes. Metformin is the main medication, since it not only lowers the blood sugar, but may also reduce the risk of developing pancreatic cancer.
• Severe Disease. It’s most often treated like Type 1 diabetes. Insulin is required to control blood sugar.

Dr. Trachtenbarg says people diagnosed with Type 3c, will also need treatment for digestive problems. That includes taking pancreatic enzymes by mouth to help with digestion. Those who suffer with Type 3c also often need vitamins, because they struggle to absorb vitamins A, D, E and K. In fact, Dr. Trachtenbarg says Vitamin D needs to be replaced in 90 percent of people with Type 3c diabetes.

People with Type 3c diabetes should also avoid:

• High sugar foods
• Alcohol
• Smoking
• Medications that could damage the pancreas

Why is Type 3c Diabetes Difficult to Diagnose?

“Type 1 and Type 2 have clear standards for diagnosing and treating. Unfortunately, Type 3c diabetes doesn’t have these clear standards. There are many causes. The experts cannot agree on a standard for diagnosis and many people have mild causes without symptoms,” Dr. Trachtenbarg says.

He says Type 3c diabetes is only diagnosed in one to two percent of patients with diabetes. However, he adds when Type 1 and Type 2 diabetes patients are specifically tested for Type 3c, about 8 percent of people are identified as having undiagnosed diabetes Type 3c. If you have diabetes and notice digestive issues, talk to your doctor about additional tests.