A type of diabetes, dubbed diabetes type-3c, may often go undiagnosed in adults, physicians in the city say, while stressing the need for diabetics to keep their doctor appointments.
While diabetes type-1 and type-2 are widely known, other less common and relatively unknown types of diabetes exist, which may be mislabelled as more common variants. Diabetes type-3c, also commonly referred to as diabetes of exocrine pancreas, is a consequence of damage to the pancreas that produces insulin. A recent study published in American Diabetes Association journal Diabetes Care suggests that this type has been misdiagnosed for type-2 diabetes in England. The study found that as many 559 cases of type-3c diabetes were misdiagnosed as type-2 diabetes in the last 10 years.
Doctors in the city concur misdiagnosis can occur, sometimes at the cost of patient health, if a course correction does not quickly ensue. “If a diabetic’s pancreatitis goes undetected, it is possible that a misdiagnosis can occur. In roughly about half the cases of chronic pancreatitis in south India, a condition that we call tropical pancreatitis does not produce apparent symptoms in affected individuals,” said K.S. Soma Shekar Rao, a gastroenterologist at Apollo Hospitals.
He added that such patients, if they fail to follow up on their treatment, continue to be treated as type-2 cases, increasing risk of organ damage, besides missing out on treatment necessary for pancreas. Type-3c diabetes treatment often needs insulin administration, unlike type-2 diabetes that is treated with medications to overcome insulin resistance in the body, Dr. Soma Shekar said.
Studies indicate that the link between diabetes and chronic pancreatitis can be missed, leading to diagnosis of type-2 even if an individual’s pancreatic history is known. This has been attributed to high prevalence and likelihood of type-2 in the middle-aged and elderly populations, that are also likely to have pancreatitis.
According to Harith Reddy, diabetologist at the Asian Institute of Gastroenterology, a physician’s diagnosis depends on the patient’s presentation.
“Increasingly today, we are not labelling the type of a patient’s diabetes up on diagnosis. Type-3c diabetes requires certain criterion to be fulfilled which can only be assessed during a series of check-ups after diagnosis of diabetes mellitus,” Dr. Reddy said.
Doctors say that the scope for missing type-3c diabetes is greatly reduced when a patient follows up on treatment. If high levels of blood sugar do not respond as expected to treatment for type-2 diabetes, subsequent assessments can show a physician if the problem lies in the pancreas. If imaging and blood tests reveal pancreas insufficiency, a diagnosis of type-3c may be made.