How Pancreatitis Is Linked to Diabetes

Research shows that inflammation of the pancreas, also known as pancreatitis, can increase the risk of developing diabetes, a condition characterized by higher-than-normal blood glucose (sugar) levels. Additionally, people with diabetes are at higher risk for pancreatitis.

Pancreatitis or diabetes may cause your body not to regulate blood glucose levels properly, which is why they are often linked to each other. Learn about the connection between these conditions and how you can reduce your risk for them.

Your Pancreas and Blood Sugar

The pancreas is an organ in your upper abdomen that is responsible for many functions, including creating and releasing digestive enzymes and producing hormones that help regulate blood glucose levels.

Insulin and glucagon are two hormones made in and released by the pancreas that regulate blood glucose levels. Insulin works to lower blood glucose levels by acting as a key to open cells, allowing glucose to leave the bloodstream and enter cells to be used for energy.

Conversely, glucagon is sent to the liver to promote the breakdown of glycogen to glucose (called glycogenolysis). This helps raise blood glucose levels when they are too low, a condition known as hypoglycemia.

What Is Pancreatitis?

Pancreatitis is inflammation of the pancreas. It can be acute, lasting only a few days, or chronic, lasting many years. The main symptom of pancreatitis is a pain in your upper abdomen that may spread to your back. However, the pain may be felt in different ways depending on if you have acute or chronic pancreatitis.

Common causes of pancreatitis include gallstones, high triglyceride levels, obesity, smoking, and heavy alcohol use.

How Diabetes and Pancreatitis Are Connected

The pancreas releases the hormones insulin and glucagon that help your body process glucose. Over time, chronic inflammation can damage the pancreas and its cells, including those that produce insulin and glucagon.

Researchers propose that this damage causes the pancreas to have trouble producing these blood glucose-regulating hormones, increasing the risk of developing diabetes. And it's thought that high blood glucose levels can lead to health problems that are bothersome for the pancreas, causing it to inflame.

Pancreatogenic Diabetes

Pancreatogenic diabetes is a form of secondary diabetes, called type 3c diabetes by the American Diabetes Association (ADA), or termed pancreoprivic diabetes. Both insulin and glucagon production and secretion are decreased in pancreatogenic diabetes. Additionally, there is often a higher-than-expected insulin demand.

Many pancreatogenic diabetes cases result from chronic pancreatitis. Damage to the pancreas from inflammation interrupts its complex roles, including nutrient digestion, absorption, and utilization. This results in a lack of insulin and glucagon production and other hormones essential for digestion. 

Decreased insulin secretion is ultimately responsible for the development of pancreatogenic diabetes. Decreased glucagon secretion and the resulting impaired glucose made in the liver also contribute to blood glucose fluctuations, with low blood glucose reactions.

Shared Risk Factors 

If you have diabetes, research shows that you are more likely to get pancreatitis. A population-based cohort study in Taiwan found that people with diabetes had a nearly two-fold increased risk of acute pancreatitis compared to people without diabetes.

In an observational study of Japanese patients with type 2 diabetes, there was a significantly increased risk of acute pancreatitis compared to those without diabetes. Risk increased with age and was also higher in males compared to females.

Another study looked into the pathophysiology behind why diabetes increases the risk for acute pancreatitis. The researchers hypothesized that insulin resistance and high blood glucose levels, both characteristics of type 2 diabetes, are important factors associated with the higher risk of acute pancreatitis in people with diabetes.

Diabetes Medications

Research suggests that certain diabetes medications may increase the risk of pancreatitis. However, several studies have provided mixed results. Drug-induced acute pancreatitis is rare, occurring in about 0.5% of cases.

Nevertheless, it is essential to be aware of the potential side effects of medications before taking them. The different diabetes medicines proposed to be associated with a higher risk of pancreatitis include glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors.

Older case reports suggested that exenatide (a GLP-1 receptor agonist) increased the risk for pancreatitis. However, these reports did not consider that those taking exenatide had diabetes and were at an increased risk of pancreatitis before taking the drug. Further and more concrete studies found that exenatide does not increase the risk of pancreatitis.

Another diabetes medication called sitagliptin, a DPP-4 inhibitor, is also thought to increase the risk of pancreatitis. Older research reported that sitagliptin was not associated with an increased risk of pancreatitis. However, newer research and preclinical data show an association or a small increased risk.

Pancreatitis has been reported in clinical trials for the GIP (glucose-dependent insulinotropic polypeptide) and GLP 1 receptor agonist tirzepatide. Although the drug has not been studied in people with a history of pancreatitis, it is recommended that use be discontinued if pancreatitis is suspected. 

With such mixed results, more research is needed to verify the claim that some medications used to treat diabetes raise the risk of pancreatitis.

Symptoms of Pancreatitis

Acute pancreatitis symptoms may come on slowly or suddenly and range in severity from mild to intense. Other symptoms include fever, nausea, vomiting, a fast heartbeat, and a swollen or tender abdomen. People with acute pancreatitis need to urgently see a healthcare provider, as they often feel very ill.

People with chronic pancreatitis may have pain in the upper abdomen, spreading to the back, or feeling no pain. The pain can become worse and more constant over time or after eating. However, the pain may also fade as the condition worsens. Other symptoms include diarrhea; nausea; vomiting; bulkier, foul-smelling stools, and weight loss.

When to See a Provider

Severe or persistent pancreatitis symptoms may signify more serious issues, such as a blockage of the pancreas or an infection. Call your healthcare provider right away or get emergency help if you experience any of the following:

• Intense, constant abdominal pain
• Shakiness, dizziness, or lightheadedness
• Nausea or vomiting
• Fatigue and lethargy
• Breathing problems
• Very fast heartbeat
• Fever
• Chills
• Unintentional weight loss
• Yellow coloring of the skin and/or whites of the eyes (jaundice)
• Greasy, foul-smelling stool
• Any new or worsening symptoms of pancreatitis

Reducing Your Risk

If you have diabetes, there are several things you can do to help reduce your risk of pancreatitis. These include keeping your blood glucose levels in a healthy range, managing your triglyceride levels, maintaining a healthy weight, only drinking alcohol in moderation or not at all, and not smoking. 

To help decrease your risk of diabetes, especially if you have pancreatitis, make sure you are getting regular checkups with your healthcare provider. Eating a healthy, balanced diet and engaging in regular physical activity can go a long way in helping with disease prevention.

Summary

Research shows that pancreatitis can increase your risk of developing diabetes, and if you have diabetes, your risk of developing pancreatitis is increased. Common ways to decrease your risk of developing both conditions include maintaining a healthy weight and exercising regularly.

A Word From Verywell

Simply because you have been diagnosed with diabetes doesn’t mean that you will go on to develop pancreatitis. Many people with diabetes can successfully manage the condition without any additional health complications. Similarly, having pancreatitis doesn’t mean you will develop diabetes. 

Your pancreas plays an essential role in blood glucose regulation in your body. Because of this, you may want to talk to your healthcare professional about the connections between pancreatitis and diabetes. They can explain the associations between the two conditions and help you navigate your individualized treatment plan for the best possible care and risk reduction.