Chronic pancreatitis and diabetes mellitus: a review of the literature

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Background: For a long time there has been a discussion about how chronic pancreatitis (CP) and diabetes mellitus (DM) are related to each other. If a patient has both conditions, should they be viewed as two separate disorders, or one of them is a plausible consequence of the other? If the latter is true, what are pathophysiological mechanisms of DM in CP? Current consensus documents by specialists in pancreatic diseases pay little attention to this issue, and their main statements have low level of evidence. The Russian consensus on the diagnosis and treatment of CP (2016) contains no statements on DM. In the Russian guidelines and consensus documents to be developed, it is necessary to include provisions on the pancreatogenic DM as an independent “other type DM’, with consideration of its pathophysiological mechanisms and clinical particulars.

Aim: To characterize the state-of-the-art in pancreatogenic DM, to demonstrate its differences from DM types 1 and 2 from pathogenetic and clinical perspectives.

Methods: The review is based on the results of meta-analyses, systematic reviews and main provisions of the existing clinical guidelines and consensus documents available from PubMed and E-library.

Results: According to various sources, Type 3c DM, or latent impaired glucose tolerance in CP, can eventually develop in 25 to 80% patients with CP. Impaired glucose tolerance is found in 40 to 60% of patients with acute pancreatitis, with persistent hyperglycemia after acute episode seen in 15 to 18% of the patients. Exocrine pancreatic insufficiency is commonly seen in Type 1 and Type 2 diabetic patients, although the data on its prevalence are highly contradictory indicating a lack of knowledge in the field. Type 3c DM is characterized by its manifestation at later stages of CP, concomitant excretory deficiency of the pancreas, brittle course with proneness to hypoglycemia and no ketoacidosis. The highest risk group includes patients with longstanding CP, previous partial pancreatic resection and patients with early calcifying pancreatitis, mainly of the alcoholic origin. Optimal and rational medical treatment of pancreatogenic DM still remains disputable, while the evidence base of the efficacy and safety of various anti-diabetic agents in this disease is lacking, and no consensus on the issue has been yet reached. General treatment guidelines given in a number of international consensus documents are limited to cautious insulin administration.

Conclusion: Pancreatogenic DM differs from Type 1 and Type 2 DM in a number of aspects, namely, mechanisms of hyperglycemia, hormonal profiles, clinical particulars and treatment approaches. Endocrine pancreatic insufficiency in CP is caused by secondary inflammatory injury of the pancreatic islets. The key to specifics of Type 3c DM lies in anatomical and physiological interplay of the exocrine and endocrine compartments of the pancreas. At presents, most provisions on pancreatogenic DM are empirical and seem to be rather declarative, because intrinsic mechanisms of this type of diabetes and moreover its pathogenetically based treatment have been poorly studied. Nevertheless, all patients with CP or other pancreatic diseases should be assessed for pancreatogenic DM.

About the authors

E. Yu. Lomakina

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.

Ekaterina Yu. Lomakina – MD, Junior Research Fellow, Department of Gastroenterology

61/2 Shchepkina ul., Moscow, 129110

Russian Federation

O. V. Taratina

Moscow Regional Research and Clinical Institute (MONIKI)

ORCID iD: 0000-0001-6112-6609

Olesya V. Taratina – MD, PhD, Research Fellow, Department of Gastroenterology; Associate Professor, Chair of Gastroenterology, Postgraduate Training Faculty

61/2 Shchepkina ul., Moscow, 129110

Russian Federation

E. A. Belousova

Moscow Regional Research and Clinical Institute (MONIKI)

ORCID iD: 0000-0003-4523-3337

Elena A. Belousova – MD, PhD, Professor, Head of Department of Gastroenterology, Head of Chair of Gastroenterology, Postgraduate Training Faculty

61/2 Shchepkina ul., Moscow, 129110

Russian Federation


  1. el Newihi H, Dooley CP, Saad C, Staples J, Zeidler A, Valenzuela JE. Impaired exocrine pancreatic function in diabetics with diarrhea and peripheral neuropathy. Dig Dis Sci. 1988;33(6): 705–10. doi: 10.1007/bf01540434.
  2. Ewald N, Hardt PD. Diagnosis and treatment of diabetes mellitus in chronic pancreatitis. World J Gastroenterol. 2013;19(42): 7276–81. doi: 10.3748/wjg.v19.i42.7276.
  3. Lohr JM, Dominguez-Munoz E, Rosendahl J, Besselink M, Mayerle J, Lerch MM, Haas S, Akisik F, Kartalis N, Iglesias-Garcia J, Keller J, Boermeester M, Werner J, Dumonceau JM, Fockens P, Drewes A, Ceyhan G, Lindkvist B, Drenth J, Ewald N, Hardt P, de Madaria E, Witt H, Schneider A, Manfredi R, Brondum FJ, Rudolf S, Bollen T, Bruno M; HaPanEU/UEG Working Group. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU). United European Gastroenterol J. 2017;5(2): 153–99. doi: 10.1177/2050640616684695.
  4. Rickels MR, Bellin M, Toledo FG, Robertson RP, Andersen DK, Chari ST, Brand R, Frulloni L, Anderson MA, Whitcomb DC; PancreasFest Recommendation Conference Participants. Detection, evaluation and treatment of diabetes mellitus in chronic pancreatitis: recommendations from PancreasFest 2012. Pancreatology. 2013;13(4): 336–42. doi: 10.1016/j.pan.2013.05.002.
  5. Хатьков ИЕ, Маев ИВ, Абдулхаков СР, Алексеенко СА, Алиханов РБ, Бакулин ИГ, Бакулина НВ, Барановский АЮ, Белобородова ЕВ, Белоусова ЕА, Восканян СЭ, Винокурова ЛВ, Гриневич ВБ, Дарвин ВВ, Дубцова ЕА, Дюжева TГ, Егоров ВИ, Ефанов МГ, Израилов РЕ, Коробка ВЛ, Котив БН, Коханенко НЮ, Кучерявый ЮА, Ливзан МА, Лядов ВК, Никольская КА, Осипенко МФ, Пасечников ВД, Плотникова ЕЮ, Саблин ОА, Симаненков ВИ, Цвиркун ВВ, Цуканов ВВ, Шабунин АВ, Бордин ДС; Профессиональное медицинское сообщество «Панкреатологический клуб». Российский консенсус по экзои эндокринной недостаточности поджелудочной железы после хирургического лечения. Терапевтический архив. 2018;(8): 13–26. doi: 10.26442/terarkh201890813-26.
  6. Śliwińska-Mossoń M, Milnerowicz S, Milnerowicz H. Diabetes mellitus secondary to pancreatic diseases (type 3c): The effect of smoking on the exocrine-endocrine interactions of the pancreas. Diab Vasc Dis Res. 2018;15(3): 243– 59. doi: 10.1177/1479164118764062.
  7. Blumenthal HT, Probstein JG, Berns AW. Interrelationship of diabetes mellitus and pancreatitis. Arch Surg. 1963;87:844–50. doi: 10.1001/archsurg.1963.01310170130022.
  8. Duggan SN, Ewald N, Kelleher L, Griffin O, Gibney J, Conlon KC. The nutritional management of type 3c (pancreatogenic) diabetes in chronic pancreatitis. Eur J Clin Nutr. 2017;71(1): 3–8. doi: 10.1038/ejcn.2016.127.
  9. Malka D, Hammel P, Sauvanet A, Rufat P, O'Toole D, Bardet P, Belghiti J, Bernades P, Ruszniewski P, Levy P. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology. 2000;119(5): 1324–32. doi: 10.1053/gast.2000.19286.
  10. Hart PA, Bellin MD, Andersen DK, Bradley D, Cruz-Monserrate Z, Forsmark CE, Goodarzi MO, Habtezion A, Korc M, Kudva YC, Pandol SJ, Yadav D, Chari ST; Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC). Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol. 2016;1(3): 226–37. doi: 10.1016/S2468-1253(16)30106-6.
  11. Губергриц НБ, Беляева НВ. Экзои эндокринная функции поджелудочной железы: один шаг от дуэта до дуэли. Сучасна гастроентерологiя. 2006;30(4): 18–30.
  12. Цымбалюк ВЮ, Кокуева ОВ, Новоселя НВ, Цымбалюк ИЮ, Середа СА. Состояние углеводного обмена и инкретинового статуса при патологии панкреатодуоденальной зоны. Кубанский научный медицинский вестник. 2010;(3–4): 196–201.
  13. Губергриц НБ, Фоменко ПГ, Колкина ВЯ. Внешнесекреторная недостаточность поджелудочной железы при сахарном диабете. Российский журнал гастроэнтерологии, гепатологии и колопроктологии. 2009;19(5): 61–7.
  14. Баранов СА, Нечаев ВМ. Поджелудочная железа как единый функционально взаимосвязанный орган. Медицинский совет. 2017;(11): 148–51. doi: 10.21518/2079-701X2017-11-148-151.
  15. Talukdar R, Sasikala M, Pavan Kumar P, Rao GV, Pradeep R, Reddy DN. T-helper cell-mediated islet inflammation contributes to β-cell dysfunction in chronic pancreatitis. Pancreas. 2016;45(3): 434–42. doi: 10.1097/MPA.0000000000000479.
  16. Murakami T, Hitomi S, Ohtsuka A, Taguchi T, Fujita T. Pancreatic insulo-acinar portal systems in humans, rats, and some other mammals: scanning electron microscopy of vascular casts. Microsc Res Tech. 1997;37(5–6): 478–88. doi: 10.1002/(SICI)1097-0029(19970601)37:5/6<478::AIDJEMT10>3.0.CO;2-N.
  17. Berg T, Johansen L, Brekke IB. Insulin potentiates cholecystokinin (CCK)-induced secretion of pancreatic kallikrein. Acta Physiol Scand. 1985;123(1): 89–95. doi: 10.1111/j.17481716.1985.tb07565.x.
  18. Duan RD, Wicker C, Erlanson-Albertsson C. Effect of insulin administration on contents, secretion, and synthesis of pancreatic lipase and colipase in rats. Pancreas. 1991;6(5): 595–602. doi: 10.1097/00006676-199109000-00014.
  19. Sofrankova A. Effect of exogenous and endogenous insulin on the secretory response of the pancreas to the octapeptide of cholecystokinin (CCK8) in normal rats. Physiol Bohemoslov. 1984;33(5): 391–8.
  20. Kanno T, Saito A. The potentiating influences of insulin on pancreozymin-induced hyperpolarization and amylase release in the pancreatic acinar cell. J Physiol. 1976;261(3): 505–21. doi: 10.1113/jphysiol.1976.sp011571.
  21. Singh J, Adeghate E. Effects of islet hormones on nerve-mediated and acetylcholine-evoked secretory responses in the isolated pancreas of normal and diabetic rats. Int J Mol Med. 1998;1(3): 627–34. doi: 10.3892/ijmm.1.3.627.
  22. Dermott JM, Gooya JM, Asefa B, Weiler SR, Smith M, Keller JR. Inhibition of growth by p205: a nuclear protein and putative tumor suppressor expressed during myeloid cell differentiation. Stem Cells. 2004;22(5): 832–48. doi: 10.1634/stemcells.22-5-832.
  23. Pierzynowski SG, Podgurniak P, Mikołajczyk M, Szczesny W. Insulin and the parasympathetic dependence of pancreatic juice secretion in healthy and alloxan diabetic sheep. Q J Exp Physiol. 1986;71(3): 401–7. doi: 10.1113/expphysiol.1986.sp002998.
  24. Yang YK, Zhu WY. [Effect of insulin on the function of pancreatic exocrine]. Sheng Li Xue Bao. 1995;47(3): 238–44. Chinese.
  25. Alvarez C, Lopez MA. Effect of alloxan diabetes on exocrine pancreatic secretion in the anesthetized rabbit. Int J Pancreatol. 1989;5(3): 229–38. doi: 10.1007/bf02924468.
  26. Ferrer R, Medrano J, Diego M, Calpena R, Graells L, Molto M, Perez T, Perez F, Salido G. Effect of exogenous insulin and glucagon on exocrine pancreatic secretion in rats in vivo. Int J Pancreatol. 2000;28(1): 67–75. doi: 10.1385/IJGC:28:1:67.
  27. Logsdon CD. Stimulation of pancreatic acinar cell growth by CCK, epidermal growth factor, and insulin in vitro. Am J Physiol. 1986;251(4 Pt 1):G487–94. doi: 10.1152/ajpgi.1986.251.4.G487.
  28. Williams JA, Goldfine ID. The insulin-pancreatic acinar axis. Diabetes. 1985;34(10): 980–6. doi: 10.2337/diab.34.10.980.
  29. Keller J, Layer P. Acinar-islet interactions: Pancreatic exocrine insufficiency in diabetes mellitus. In: Johnson CD, Imrie CW, editors. Pancreatic disease. Basic science and clinical management. Springer Verlag: London; 2004. p. 267–78. doi: 10.1007/978-1-85233-9043_21.
  30. Biedzinski TM, Bataille D, Devaux MA, Sarles H. The effect of oxyntomodulin (glucagon-37) and glucagon on exocrine pancreatic secretion in the conscious rat. Peptides. 1987;8(6): 967–72. doi: 10.1016/0196-9781(87)90122-7.
  31. Itoh H, Matsuyama T, Namba M, Watanabe N, Komatsu R, Kono N, Tarui S. Effect of glucagon-( 1-21)-peptide on secretin-stimulated pancreatic exocrine secretion in anesthetized dogs. Life Sci. 1989;44(12): 819–25. doi: 10.1016/0024-3205(89)90379-2.
  32. Harada H, Kochi F, Hanafusa E, Kobayashi T, Oka H, Kimura I. Studies on the effect of glucagon on human pancreatic secretion by analysis of endoscopically obtained pure pancreatic juice. Gastroenterol Jpn. 1985;20(1): 28–36. doi: 10.1007/bf02774671.
  33. Wettergren A, Schjoldager B, Mortensen PE, Myhre J, Christiansen J, Holst JJ. Truncated GLP-1 (proglucagon 78-107-amide) inhibits gastric and pancreatic functions in man. Dig Dis Sci. 1993;38(4): 665–73. doi: 10.1007/bf01316798.
  34. Adler G. Effect of glucagon on the secretory process in the rat exocrine pancreas. Cell Tissue Res. 1977;182(2): 193–204. doi: 10.1007/bf00220588.
  35. Jarett L, Lacy PE. Effect of glucagon on the acinar portion of the pancreas. Endocrinology. 1962;70:867–73. doi: 10.1210/endo-70-6-867.
  36. Papp M, Feher S, Varga B, Folly G. Humoral influences on local blood flow and external secretion of the resting dog pancreas. Acta Med Acad Sci Hung. 1977;34(4): 185–8.
  37. Dreiling DA, Janowitz HD, Haemmerli UP, Marshall D. The effect of glucagon on the exocrine pancreatic secretion of man. J Mt Sinai Hosp N Y. 1958;25(3): 240–3.
  38. Shaw HM, Heath TJ. The effect of glucagon on the formation of pancreatic juice and bile in the rat. Can J Physiol Pharmacol. 1973;51(1): 1–5. doi: 10.1139/y73-001.
  39. Emoto T, Miyata M, Izukura M, Yumiba T, Mizutani S, Sakamoto T, Matsuda H. Simultaneous observation of endocrine and exocrine functions of the pancreas responding to somatostatin in man. Regul Pept. 1997;68(1): 1–8. doi: 10.1016/s0167-0115(96)00125-5.
  40. von der Ohe M, Layer P, Wollny C, Ensinck JW, Peeters TL, Beglinger C, Goebell H. Somatostatin 28 and coupling of human interdigestive intestinal motility and pancreatic secretion. Gastroenterology. 1992;103(3): 974–81. doi: 10.1016/0016-5085(92)90031-s.
  41. Czako L, Hegyi P, Rakonczay Z Jr, Wittmann T, Otsuki M. Interactions between the endocrine and exocrine pancreas and their clinical relevance. Pancreatology. 2009;9(4): 351–9. doi: 10.1159/000181169.
  42. Henderson JR. Why are the islets of Langerhans? Lancet. 1969;2(7618): 469–70. doi: 10.1016/s0140-6736(69)90171-8.
  43. Ewald N, Bretzel RG. Diabetes mellitus secondary to pancreatic diseases (Type 3c) – are we neglecting an important disease? Eur J Intern Med. 2013;24(3): 203–6. doi: 10.1016/j.ejim.2012.12.017.
  44. de-Madaria E, Abad-Gonzalez A, Aparicio JR, Aparisi L, Boadas J, Boix E, de-LasHeras G, Dominguez-Munoz E, Farre A, Fernandez-Cruz L, Gomez L, Iglesias-Garcia J, Garcia-Malpartida K, Guarner L, Larino-Noia J, Lluis F, Lopez A, Molero X, Moreno-Perez O, Navarro S, Palazon JM, Perez-Mateo M, Sabater L, Sastre Y, Vaquero EC, Martinez J. The Spanish Pancreatic Club's recommendations for the diagnosis and treatment of chronic pancreatitis: part 2 (treatment). Pancreatology. 2013;13(1): 18–28. doi: 10.1016/j.pan.2012.11.310.
  45. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus. World Health Organization; 1999 [Internet]. Available from:
  46. Дедов ИИ, Шестакова МВ, Майоров АЮ, Викулова ОК, Галстян ГР, Кураева ТЛ, Петеркова ВА, Смирнова ОМ, Старостина ЕГ, Суркова ЕВ, Сухарева ОЮ, Токмакова АЮ, Шамхалова МШ, Ярек-Мартынова ИР, Артемова ЕВ, Бешлиева ДД, Бондаренко ОН, Волеводз НН, Григорян ОР, Гомова ИС, Джемилова ЗН, Есаян РМ, Ибрагимова ЛИ, Калашников ВЮ, Кононенко ИВ, Лаптев ДН, Липатов ДВ, Мотовилин ОГ, Никонова ТВ, Роживанов РВ, Шестакова ЕА. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова. 9-й вып. Сахарный диабет. 2019;22(S1): 1–144. doi: 10.14341/DM221S1.
  47. Gao W, Zhou Y, Li Q, Zhou Q, Tan L, Song Y, Zhao X, Yu M, Zheng S, Ye H, Zeng B, Lin Q, Zhou J, Liu Y, Huang H, Zhang H, Hu X, Li Z, Dai X, Chen R. Analysis of global gene expression profiles suggests a role of acute inflammation in type 3C diabetes mellitus caused by pancreatic ductal adenocarcinoma. Diabetologia. 2015;58(4): 835–44. doi: 10.1007/s00125014-3481-8.
  48. Uc A, Andersen DK, Bellin MD, Bruce JI, Drewes AM, Engelhardt JF, Forsmark CE, Lerch MM, Lowe ME, Neuschwander-Tetri BA, O'Keefe SJ, Palermo TM, Pasricha P, Saluja AK, Singh VK, Szigethy EM, Whitcomb DC, Yadav D, Conwell DL. Chronic Pancreatitis in the 21st Century – Research Challenges and Opportunities: Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop. Pancreas. 2016;45(10): 1365–75. doi: 10.1097/MPA.0000000000000713.
  49. Martinez J, Abad-Gonzalez A, Aparicio JR, Aparisi L, Boadas J, Boix E, de las Heras G, Dominguez-Munoz E, Farre A, FernandezCruz L, Gomez L, Iglesias-Garcia J, Garcia-Malpartida K, Guarner L, Larino-Noia J, Lluis F, Lopez A, Molero X, Moreno-Perez O, Navarro S, Palazon JM, Perez-Mateo M, Sabater L, Sastre Y, Vaquero EC, De-Madaria E; Club Espanol Pancreatico (CEP). [Recommendations of the Spanish Pancreatic Club on the diagnosis and treatment of chronic pancreatitis: part 1 (diagnosis)]. Gastroenterol Hepatol. 2013;36(5): 326–39. doi: 10.1016/j.gastrohep.2012.12.004.Spanish.
  50. Губергриц НБ, Лукашевич ГМ, Голубова ОА, Беляева НВ, Загоренко ЮА. Панкреатогенный сахарный диабет. Российский журнал гастроэнтерологии, гепатологии и колопроктологии. 2007;17(6): 11–6.
  51. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37 Suppl 1:S81–90. doi: 10.2337/dc14-S081.
  52. Andersen DK, Korc M, Petersen GM, Eibl G, Li D, Rickels MR, Chari ST, Abbruzzese JL. Diabetes, Pancreatogenic Diabetes, and Pancreatic Cancer. Diabetes. 2017;66(5): 1103–10. doi: 10.2337/db16-1477.
  53. Cui Y, Andersen DK. Pancreatogenic diabetes: special considerations for management. Pancreatology. 2011;11(3): 279–94. doi: 10.1159/000329188.
  54. Ewald N, Kaufmann C, Raspe A, Kloer HU, Bretzel RG, Hardt PD. Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c). Diabetes Metab Res Rev. 2012;28(4): 338–42. doi: 10.1002/dmrr.2260.
  55. Pan J, Xin L, Wang D, Liao Z, Lin JH, Li BR, Du TT, Ye B, Zou WB, Chen H, Ji JT, Zheng ZH, Hu LH, Li ZS. Risk Factors for diabetes mellitus in chronic pancreatitis: a cohort of 2011 patients. Medicine (Baltimore). 2016;95(14):e3251. doi: 10.1097/MD.0000000000003251.
  56. Watanabe S, Nagashio Y, Asaumi H, Nomiyama Y, Taguchi M, Tashiro M, Kihara Y, Nakamura H, Otsuki M. Pressure activates rat pancreatic stellate cells. Am J Physiol Gastrointest Liver Physiol. 2004;287(6):G1175–81. doi: 10.1152/ajpgi.00339.2004.
  57. Nomiyama Y, Tashiro M, Yamaguchi T, Watanabe S, Taguchi M, Asaumi H, Nakamura H, Otsuki M. High glucose activates rat pancreatic stellate cells through protein kinase C and p38 mitogen-activated protein kinase pathway. Pancreas. 2007;34(3): 364–72. doi: 10.1097/MPA.0b013e31802f0531.
  58. Hardt PD, Hauenschild A, Nalop J, Marzeion AM, Jaeger C, Teichmann J, Bretzel RG, Hollenhorst M, Kloer HU; S2453112/ S2453113 Study Group. High prevalence of exocrine pancreatic insufficiency in diabetes mellitus. A multicenter study screening fecal elastase 1 concentrations in 1,021 diabetic patients. Pancreatology. 2003;3(5): 395–402. doi: 10.1159/000073655.
  59. Ewald N, Raspe A, Kaufmann C, Bretzel RG, Kloer HU, Hardt PD. Determinants of Exocrine Pancreatic Function as Measured by Fecal Elastase-1 Concentrations (FEC) in Patients with Diabetes mellitus. Eur J Med Res. 2009;14(3): 118–22. doi: 10.1186/2047-783x14-3-118.
  60. Terzin V, Varkonyi T, Szabolcs A, Lengyel C, Takacs T, Zsori G, Stajer A, Palko A, Wittmann T, Palinkas A, Czako L. Prevalence of exocrine pancreatic insufficiency in type 2 diabetes mellitus with poor glycemic control. Pancreatology. 2014;14(5): 356–60. doi: 10.1016/j.pan.2014.07.004.
  61. Young AA, Cooper GJ, Carlo P, Rink TJ, Wang MW. Response to intravenous injections of amylin and glucagon in fasted, fed, and hypoglycemic rats. Am J Physiol. 1993;264(6 Pt 1):E943–50. doi: 10.1152/ajpendo.1993.264.6.E943.
  62. Panicot L, Mas E, Thivolet C, Lombardo D. Circulating antibodies against an exocrine pancreatic enzyme in type 1 diabetes. Diabetes. 1999;48(12): 2316–23. doi: 10.2337/diabetes.48.12.2316.
  63. Taniguchi T, Okazaki K, Okamoto M, Seko S, Tanaka J, Uchida K, Nagashima K, Kurose T, Yamada Y, Chiba T, Seino Y. High prevalence of autoantibodies against carbonic anhydrase II and lactoferrin in type 1 diabetes: concept of autoimmune exocrinopathy and endocrinopathy of the pancreas. Pancreas. 2003;27(1): 26– 30. doi: 10.1097/00006676-200307000-00004.
  64. Chakraborty PP, Chowdhury S. A look inside the pancreas: the “Endocrine-Exocrine Crosstalk”. Endocrinol Metab Synd. 2015;4(1): 160. doi: 10.4172/2161-1017.1000160.
  65. Воевода МИ, Иванова АА, Шахтшнейдер ЕВ, Овсянникова АК, Михайлова СВ, Астракова КС, Воевода СМ, Рымар ОД. Молекулярная генетика MODY. Терапевтический архив. 2016;(4): 117–24. doi: 10.17116/terarkh2016884117124.
  66. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению хронического панкреатита. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2013;23(1): 66–87.
  67. Makuc J. Management of pancreatogenic diabetes: challenges and solutions. Diabetes Metab Syndr Obes. 2016;9:311–5. doi: 10.2147/DMSO.S99701.
  68. Frulloni L, Falconi M, Gabbrielli A, Gaia E, Graziani R, Pezzilli R, Uomo G, Andriulli A, Balzano G, Benini L, Calculli L, Campra D, Capurso G, Cavestro GM, De Angelis C, Ghezzo L, Manfredi R, Malesci A, Mariani A, Mutignani M, Ventrucci M, Zamboni G, Amodio A, Vantini I; Italian Association for the Study of the Pancreas (AISP), Bassi C, Delle Fave G, Frulloni L, Vantini I, Falconi M, Frulloni L, Gabbrielli A, Graziani R, Pezzilli R, Capurso IV, Cavestro GM, De Angelis C, Falconi M, Gaia E, Ghezzo L, Gabbrielli A, Graziani R, Manfredi R, Malesci A, Mariani A, Mutignani M, Pezzilli R, Uomo G, Ventrucci M, Zamboni G, Vantini I, Magarini F, Albarello L, Alfieri S, Amodio A, Andriulli A, Anti M, Arcidiacono P, Baiocchi L, Balzano G, Benini L, Berretti D, Boraschi P, Buscarini E, Calculli L, Carroccio A, Campra D, Celebrano MR, Capurso G, Casadei R, Cavestro GM, Chilovi F, Conigliaro R, Dall'Oglio L, De Angelis C, De Boni M, De Pretis G, Di Priolo S, Di Sebastiano PL, Doglietto GB, Falconi M, Filauro M, Frieri G, Frulloni L, Fuini A, Gaia E, Ghezzo L, Gabbrielli A, Graziani R, Loriga P, Macarri G, Manes G, Manfredi R, Malesci A, Mariani A, Massucco P, Milani S, Mutignani M, Pasquali C, Pederzoli P, Pezzilli R, Pietrangeli M, Rocca R, Russello D, Siquini W, Traina M, Uomo G, Veneroni L, Ventrucci M, Zilli M, Zamboni G. Italian consensus guidelines for chronic pancreatitis. Dig Liver Dis. 2010;42 Suppl 6:S381–406. doi: 10.1016/S1590-8658(10)60682-2.
  69. Cui Y, Andersen DK. Diabetes and pancreatic cancer. Endocr Relat Cancer. 2012;19(5):F9–26. doi: 10.1530/ERC-12-0105.
  70. Meier JJ, Giese A. Diabetes associated with pancreatic diseases. Curr Opin Gastroenterol. 2015;31(5): 400–6. doi: 10.1097/MOG.0000000000000199.
  71. Gudipaty L, Rickels MR. Pancreatogenic (type 3c) diabetes. Pancreapedia: Exocrine Pancreas Knowledge Base. 2015. doi: 10.3998/panc.2015.35.

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