The very short answer,
@Anxious 63, is NO. T3c is not always from pancreatitis. But this short answer is unhelpful.
The type of Diabetes is diagnosed from the cause of hyperglycaemia, not the treatment.
As
@Inka has said T1 is caused by the autoimmune condition, leading to this killing off their beta cells and thus losing the ability to produce insulin. Generally insulin is the treatment but there are exceptions where oral meds are sufficient, even if only in the early stages. T1s are c.10% of diabetes diagnoses.
T2 is a consequence of high insulin resistance, generally oral meds are the starting treatment and sometimes T2s need extra insulin as well (often in seriously large quantities). T2s are the majority c. 90%.
T3cs are people who have damage to their pancreas, for a variety of reasons [other than the autoimmune condition]. They might have quite limited pancreatic damage and can start on oral meds, but might need to become insulin dependent. All of the other Types are a very small part of the D community, and other than Gestational D we all have descriptors that mean nothing to anyone not involved with D!!
I am someone who feels fairly strongly that its important that T3c is properly recognised as a Diabetes diagnosis in its own right and not just considered as a variant of T1.
I'm T3c because my pancreas was damaged by surgery. I had pancreatic cancer from a tumour that was engulfing my pancreas and the visible symptoms for that was jaundice, caused by the bile duct being strangled. Immediately before my surgery the Surgeon had formally told me that a total pancreatectomy was a possibility, but he would only know once they opened me up; if the tumour could be removed by a partial panc'y then I might even not end up diabetic - naturally I hoped it would be that way. But here I am. I found this "
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".
Curiously my Hospital paperwork discharged me as T1, which I'm clearly not. But it was put to me that by discharging me as T1 would give me 2 future advantages:
1. It would always make me eligible for Diabetic Specialist Services, ie Hospital Consults.
2. And should I end up in A& E unable to speak for myself I would always be recognised from my medical records as needing insulin.
Both those reasons have helped me reconcile that initial misleading diagnosis of T1 - but I feel I'm on a personal mission to educate any HCP I come into contact with that T3c is real and different from T1.
The much wider problem is that T3c is now officially, but quietly, recognised by the NHS, but that recognition is sadly lacking in so many NHS "corners". There is some history which explains this.
In North America, some years ago, people with dementia were called Type 3s; particularly insulin dependent diabetics. This gained some traction and an International Conference sponsored in USA by the American Diabetes Association (ADA) went several steps further in agreeing that the diagnosis of T3 would help identify insulin dependency for those unable to manage their D because of their dementia. But this was felt by delegates that it was also ducking a bigger problem of many diagnoses of diabetes simply did not fit a T1 or T2 diagnosis. In particular people who had damage to their pancreas from all sorts of circumstances and thus had their insulin production impaired (steroid and alcohol abuse were both specifically mentioned as possible causes for damage to the pancreas) fell into this 'third' Type. The Conference finished by recommending there should be several T3 sub categories, from T3a to T3k, while still adopting Type 3 for dementia sufferers. Unfortunately the World Health Organisation (WHO) and a few others didn't support the recommendations; so the new categories for all T3 types were parked, rather than being fully accepted and thus widely adopted.
Each of the proposed subtypes for T3 a-k have one clear thing in common: their pancreatic damage is a consequence of some other co-morbidity and often that co-morbidity makes management of an individual's D even more complicated than it already is from T1 or T2. The Conference proposed "
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." [We have a couple of other members of this forum who also have steroid induced pancreatic damage and thus should be considered as T3e].
I have not seen T3e referred to in any NHS formal documentation and I think if someone with steroid induced D is today described as T3c rather than T3e that would still be a huge positive step forward. They are neither T1, nor T2. But they do have damage to their pancreas and that damage is imparing their insulin production. So to my mind a T3c diagnosis is not such an inaccurate compromise.
Sorry this is so lengthy!
