Diabetes Classifications…

[JITR]

... the condition was recognised during an International Conference not many years ago when the nomenclature of Type 3 (a-k) was developed and you would fall into the proposed Type 3e. Some extracts below:

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Secondary diabetes occurs as a consequence of another medical condition. For example, cystic fibrosis, hemochromatosis, chronic pancreatitis, polycystic ovary syndrome, Cushing’s syndrome, pancreatic cancer, glucagonoma and pancreatectomy. There is also drug induced diabetes which is caused by taking certain medications. For example, corticosteroids (steroid induced diabetes), beta-blockers and thiazide diuretics.​

Usually secondary diabetes is a permanent condition, however in some cases there might be the potential to reverse the effects of hyperglycaemia. The management of secondary diabetes will depend on the condition or medication that has caused it.​

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Then followed the listing for each T3 type, including:​

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Type 3e diabetes. This form of diabetes is any diabetes that has been induced by chemical or drugs. For example, high doses of steroids, taken for an extended period of time, can lead to diabetes developing. Steroid-induced diabetes is therefore a form of type 3e diabetes.​

@Proud to be erratic

Would you be able to share a reference/link to the document containing the excerpts?

 

[Proud to be erratic]

@Proud to be erratic

Would you be able to share a reference/link to the document containing the excerpts?

Hello @JITR,

Apologies for the delay in replying, been busy and distracted since Thursday.

I don't have a reference link; but having seen what I felt was a source document a couple (+/-) of years ago that, alas, I didn't record a reference for and then found some details more recently in a magazine or journal - I did a cut and paste into my phone Notes, which I take extracts from periodically. My IT skills don't go as far as knowing how to condense those notes into a portable document, so I'm copying them verbatim from my notes.

SECONDARY DIABETES

Secondary diabetes occurs as a consequence of another medical condition. For example, cystic fibrosis, hemochromatosis, chronic pancreatitis, polycystic ovary syndrome, Cushing’s syndrome, pancreatic cancer, glucagonoma and pancreatectomy. There is also drug induced diabetes which is caused by taking certain medications. For example, corticosteroids (steroid induced diabetes), beta-blockers and thiazide diuretics.

Usually secondary diabetes is a permanent condition, however in some cases there might be the potential to reverse the effects of hyperglycaemia. The management of secondary diabetes will depend on the condition or medication that has caused it.

Type 3 diabetes

Type 3 diabetes is a name that’s been informally given to the insulin resistance in the brain that can occur in people with Alzheimer’s disease.

People with insulin resistance or type 2 diabetes are 50% and 65% more at risk of developing Alzheimer’s disease, respectively than those without.

The term type 3 diabetes has not been formally recognised and it is best to refer to Alzheimer’s disease as Alzheimer’s disease, to prevent confusion with other types of diabetes such as diabetes type 3a, 3b 3c etc.

Type 3a diabetes. Type 3a diabetes is term designated for any forms of diabetes caused by genetic defects to beta cells (the cells in the pancreas that produce insulin).

Type 3b diabetes. Type 3b is any form of diabetes caused by genetic defects that affect the action of insulin.

Type 3c diabetes. Type 3c diabetes, also known as ‘pancreatogenic diabetes’, is a form of secondary diabetes, that may occur as a result of the pancreatic disorders such as pancreatitis, cystic fibrosis, hemochromatosis, pancreatic cancer, pancreatomy and some neonatal diabetic cases caused by pancreatic agenesis.

Type 3d diabetes. Type 3d is any form of diabetes that results from hormone disorders.

Type 3e diabetes. This form of diabetes is any diabetes that has been induced by chemical or drugs. For example, high doses of steroids, taken for an extended period of time, can lead to diabetes developing. Steroid-induced diabetes is therefore a form of type 3e diabetes.

Type 3f diabetes. This form refers to diabetes that develops as the result of an infection.

Type 3g diabetes. Type 3g refers to less common immune-mediated diabetes.

Type 3h diabetes. This form is for other genetic syndromes that may be associated with diabetes occurring.

There is an anomaly in that I originally noted Type 3 with (a-k) subsidiary categories, and have frequently subsequently referred to (a-k); but I think it's probably only (a-h) and I originally noted that incorrectly. The NHS seems to now unequivocally recognise T3c, but not most of the other then proposed Type 3 subsets. We have recent postings from new members telling us that their HCP doesn't even formally recognise T3c, which is pretty disgraceful considering the NHS does now recognise this distinction. But I guess this is mainly because ICBs have not yet embraced the distinction (perhaps for funding constraints) and some old guard Consultants aren't willing to seperate T3c with full insulin dependence from T1 because the treatment is more or less the same (in their eyes - not mine!)".

So this is what I've found and noted.

 

[JITR]

Thank you so much, @Proud to be erratic, for your notes.

Looking at the International Classification of Diseases (ICD10 and now ICD11) there is more to this than I imagined;
e.g. CLASSIFICATION OF DIABETES MELLITUS 2019

I'd like to comment on your point below about NHS organising itself when I've made some time to look at a few of these documents.

.We have recent postings from new members telling us that their HCP doesn't even formally recognise T3c, which is pretty disgraceful considering the NHS does now recognise this distinction. But I guess this is mainly because ICBs have not yet embraced the distinction (perhaps for funding constraints) and some old guard Consultants aren't willing to seperate T3c with full insulin dependence from T1 because the treatment is more or less the same (in their eyes - not mine!

 

[JITR]

We have recent postings from new members telling us that their HCP doesn't even formally recognise T3c, which is pretty disgraceful considering the NHS does now recognise this distinction. But I guess this is mainly because ICBs have not yet embraced the distinction (perhaps for funding constraints) and some old guard Consultants aren't willing to seperate T3c with full insulin dependence from T1 because the treatment is more or less the same (in their eyes - not mine!

Looking at the International Classification of Diseases (ICD10 and now ICD11) there is more to this than I imagined;
e.g. CLASSIFICATION OF DIABETES MELLITUS 2019. I'd like to comment on your point about NHS organising itself when I've made some time to look at a few of these documents.

Note: placeholder for response - watch this space.

2003 Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus​

2017 Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer​

2019 CLASSIFICATION OF DIABETES MELLITUS
2020 WHO Types of Diabetes
2022 NHS Type 3
ICD-10
ICD-11

 

[everydayupsanddowns]

This conversation looks interesting, but it felt better to be moved away from the Insulin Resistance thread so that it doesn’t confuse things there 🙂

 

[JITR]

Agreed. To be continued ...

Short summary: Type 3c has been recognised for 20+ years but not always called Type 3c. WHO came up with a somewhat different classification of diabetic conditions in 2019. This provides for adding extra codes to the original code assigned at diagnosis. The WHO ICD-11 classification is very different from the 10th version that the United States modified to create the ICD-10-CM code set that is used in the US today. One key difference, ICD-11 post-coordinated code clusters, provides a flexible way to represent details about a condition. See ICD-11: Coding of Diabetes