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lüll Is pancreatic diabetes (type 3c diabetes) underdiagnosed and misdiagnosed?Hardt PD; Brendel MD; Kloer HU; Bretzel RGDiabetes Care 2008[Feb]; 31 Suppl 2 (ä): S165-9Exocrine pancreatic insufficiency is frequently associated with diabetes, with high prevalence in both insulin-dependent or insulin-independent patients. Exocrine pancreatic failure has often been perceived as a complication of diabetes. In contrast, recent clinical observations lead to the notion that nonendocrine pancreatic disease is a critical factor for development rather than a sequel to diabetes. The incidence of diabetes caused by exocrine pancreatic disease appears to be underestimated and may comprise 8% or more of the general diabetic patient population. Nonendocrine pancreas disease can cause diabetes by multiple mechanisms. Genetic defects have been characterized, resulting in a syndrome of both exocrine and endocrine failure. Regulation of beta-cell mass and physiological incretin secretion are directly dependent on normal exocrine function. Algorithms for diagnosis and therapy of diabetes should therefore address both endocrine and exocrine pancreatic function.|Diabetes Complications/epidemiology/genetics/*physiopathology[MESH]|Diabetes Mellitus/*classification/genetics/*physiopathology[MESH]|Diagnosis, Differential[MESH]|Humans[MESH]|Insulin-Secreting Cells/pathology/physiology[MESH]|Lipase/genetics[MESH]|Mutation[MESH]|Pancreas/pathology[MESH]|Pancreatic Diseases/diagnosis/epidemiology/*physiopathology[MESH]|Prevalence[MESH] |