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Diabetes mellitus type 3, or secondary diabetes, is a type of diabetes that has recently been discussed. This term covers disorders of the carbohydrate metabolism caused by various other diseases in the patient. So what conditions can cause type 3 diabetes? Is the treatment of type 3 diabetes different from the treatment of other types of diabetes?

Type 3 diabetes(orsecondary diabetes ) may manifest itself in the same way as type 1 diabetes or type 2 diabetes, similarities may also apply to and treatments for all of the types of diabetes mentioned. However, secondary diabetes is not distinguished for no reason - distinguishing it from other types of diabetes is important, if only because of the causes of type 3 diabetes. better than the prognosis of patients with other forms of diabetes.

Type 3 diabetes: causes

It has been mentioned above that type 3 diabetes is sometimes referred to as secondary - such nomenclature comes from the fact that this form of diabetes appears as a result of the existence of other diseases in the patient. These diseases can both lead to a reduction in insulin secretion by the pancreas and may result in a reduction in tissue sensitivity to insulin (i.e. insulin resistance).

The cause of type 3 diabetes can be many different pathologies, such as, for example, various endocrine disorders, neoplastic diseases, metabolic diseases or even conditions after surgery. Moving on to more specific information, it can lead to secondary diabetes:

  • hyperthyroidism
  • Cushing's syndrome
  • polycystic ovary syndrome
  • cystic fibrosis
  • pancreatitis acute and chronic pancreatitis
  • acromegaly
  • the use of certain drugs (e.g. thiazides, glucocorticosteroids, beta-blockers or interferon preparations, or atypical neuroleptics; in the case of drugs, however, it is emphasized that they do not cause diabetes by themselves, and faster accelerate the occurrence of carbohydrate disorders in humans, who are predisposed)
  • genetic disease in which the patient has an increased tendency to develop diabetes (examples of such diseases includeDown syndrome, Klinefelter syndrome, Prader-Willi syndrome and Turner syndrome)
  • cancer (e.g. pancreatic cancer, but also tumors that produce various hormones - e.g. glucagonoma, somatostatinoma or pheochromocytoma),
  • storage disorder (e.g. hemochromatosis)
  • state after pancreatic removal

The group of secondary diabetes also includes such specific forms of these diseases as several types of MODY diabetes and LADA type diabetes.

Diabetes mellitus type 3: symptoms

As far as the symptoms of carbohydrate disorders are concerned, the symptoms of patients with secondary diabetes are essentially the same as those of people with type 1 or type 2 diabetes.

Patients (especially before diagnosing the disease and starting its treatment) may experience e.g. increased thirst, may develop a tendency to consume a significantly increased amount of fluids, and may also struggle with severe hunger pangs or notice that you are passing more urine.

A characteristic feature of type 3 diabetes, however, is that - as it occurs secondary to some other disease - the patient experiences not only the symptoms of diabetes, but also this or some other disease.

It is difficult to present the range of ailments that can constitute the entirety of the symptoms of type 3 diabetes - there are many different causes of this disease, and for each of the different reasons, patients may present completely separate ailments.

To illustrate this, here is an example of two patients with type 3 diabetes: one was caused by Cushing's syndrome and the other was caused by cystic fibrosis.

In the case of the first patient, he may struggle with carbohydrate disorders, but also with obesity, stretch marks or mental disorders (all of these may be the result of an excessive amount of adrenal steroids in the body).

The second patient - suffering from cystic fibrosis - apart from the symptoms of type 3 diabetes, may also present disorders from the respiratory system (e.g. in the form of chronic respiratory infections), but also from the digestive system (e.g. in the form of absorption and fatty diarrhea).

It is worth emphasizing one but very important thing here. Well, it often happens that the patient already suffers from some carbohydrate metabolism disorders, and at the same time he does not experience any complaints because of it.

This situation is extremely dangerous, because the patient is not aware of the disease (therefore, it is rather not used by himany treatment), and at the same time hyperglycemia leads to various serious complications.

This is why regular diabetes testing (such as a fasting blood glucose test or the oral glucose loading test (OGTT)) is so important. They allow for the early detection of pre-diabetes or various forms of diabetes (including type 3 diabetes), before these problems lead to serious consequences. But what can these consequences be?

Type 3 diabetes: complications

A patient with type 3 diabetes, like a patient with type 1 or type 2 diabetes, is at increased risk of developing a variety of disorders. The complications of diabetes are mentioned here mainly from:

  • kidney
  • heart and blood vessels
  • nervous system
  • organs of vision

In general, the rate of such complications of type 3 diabetes is lower than that of other types of diabetes, but if a patient remains untreated and has abnormally high blood glucose levels, the rate of development of these complications may be as fast as that of other types of diabetes. for other types of diabetes.

Diabetes mellitus type 3: diagnosis

The basic tests that are used to diagnose diabetes (including type 3 diabetes) are glucose measurements - blood glucose level can be determined only on an empty stomach, but also in the oral glucose load test (OGTT).

If you suspect that your diabetes is actually a secondary problem, you need to do more than just measure your blood glucose. It is necessary to find the cause of type 3 diabetes - in this situation, the selection of specific tests depends on what exactly the pathology will be suspected in the patient.

If it is suspected that the patient's condition is caused by a cancer (e.g. pancreatic cancer), it will be necessary to perform diagnostic imaging - for this purpose, the patient can be subjected to abdominal MRI or CT scan of the abdominal cavity.

In turn, when Cushing's syndrome is the suspected cause of secondary diabetes, the patient may be ordered to test various hormones (mainly glucocorticosteroids) in the blood and urine.

Type 3 diabetes: treatment

The methods for treating type 3 diabetes are exactly the same as for other types of diabetes. It can be used in case of a slight carbohydrate disturbancetreatment with oral preparations - primarily metformin. In the case of significantly worse carbohydrate parameters, patients may be prescribed insulin therapy.

Above, however, only the treatment of abnormal blood glucose levels is mentioned. However, in patients with type 3 diabetes, it is also necessary to apply treatment that would directly target the cause of their diabetes. Here, the management can be very different depending on the cause of type 3 diabetes in a given patient.

If it was caused by medications taken by the patient (e.g. beta-blockers or thiazide diuretics), the discontinuation of these drugs and their replacement with other drugs may have a very beneficial effect on the stabilization of carbohydrate metabolism parameters.

In turn, for people who developed type 3 diabetes due to Cushing's syndrome, eliminating this condition (e.g. by resection of a tumor of the adrenal glands producing steroid hormones) may be a sufficient and effective method of curing a patient from type 3 diabetes.

Type 3 diabetes: prognosis

It is generally emphasized that patients with type 3 diabetes may have a much better prognosis than patients with other types of diabetes. However, they may or may not - everything depends on the cause of carbohydrate disorders.

Indeed, in some patients it is easy to reduce glycemic disorders - sometimes it turns out that it is enough to modify the patient's pharmacotherapy or to normalize the levels of thyroid or adrenal hormones.

In other patients, however - e.g. those who developed type 3 diabetes after chronic pancreatitis and those who developed the problem after pancreatic resection - treatment (in the form of insulin administration) may already be required for end of life.

Sources:

1. Global Report on Diabetes, WHO; on-line access: http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf 2. Om P. Ganda, Prevalence and Incidence of Secondary and Other Types of Diabetes, on-line access: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.510.3690&rep=rep1&type=pdf3. CS Yajnik, "Secondary diabetes", King Edward Memorial Hospital, India Materials; on-line access: http://www.kemdiabetes.org/publication/19.%20Yajnik%20.%20Secondary%20Diabetes.%20Diabetographia.pdf4. Materials portal Diabetes.co.uk; on-line access: https://www.diabetes.co.uk/secondary-diabetes.html5. Diapedia materials - The Living Textbook of Diabetes, on-line access: https://www.diapedia.org/other-types-of-diabetes-mellitus/4104085115

ABOUTauthorBow. Tomasz NęckiA graduate of the medical faculty at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Diabetes