How Pancreatitis Is Linked to Diabetes

Pancreas, illustration


The pancreas is an organ in your upper abdomen that has many functions. These include creating and releasing digestive enzymes, and producing hormones that help regulate blood glucose (sugar) levels. 

Diabetes is a medical condition characterized by higher-than-normal blood glucose levels (hyperglycemia). It is associated with the pancreas due to the blood sugar-regulating hormones produced there. 

When the pancreas is damaged or inflamed, such as with pancreatitis, its ability to carry out its essential functions is inhibited, often leading to other health problems, including diabetes. Additionally, people with diabetes are at higher risk for pancreatitis.

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 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.

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

People with chronic pancreatitis may have pain in the upper abdomen, spreading to the back, or they may feel no pain at all. 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.

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. When these cells become impaired, they are unable to properly regulate blood glucose levels, increasing the risk for diabetes.

What Are Insulin and Glucagon?

Insulin and glucagon are hormones made in and released by the pancreas. Their primary function is to regulate blood glucose (sugar) 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 (hypoglycemia).

Links Between Pancreatitis and Diabetes

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, as well as 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 being made in the liver also contribute to blood glucose fluctuations, with low blood glucose reactions.

Shared Risk Factors 

If you have diabetes, you are more likely to get pancreatitis. An observational study of Japanese patients with type 2 diabetes found 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.

Likewise, a population-based cohort study in Taiwan also found that people with type 2 diabetes had a nearly two-fold increased risk of acute pancreatitis compared to people without diabetes.

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 in type 2 diabetes, are important factors associated with the higher risk of acute pancreatitis in people with diabetes.

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

Diabetes Medications

There is research suggesting that certain diabetes medications may increase the risk of pancreatitis. However, several studies have provided mixed results. Overall, drug-induced acute pancreatitis is rare, occurring in about 0.5% of cases.

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

A 2011 review of the Food and Drug Administration’s database of reported adverse events found that pancreatitis was reported more than six-fold in patients taking exenatide (a GLP-1 receptor agonist) when compared with other therapies.

This same six-fold increase in reported pancreatitis cases was also found with patients taking another diabetes medication called sitagliptin, a DPP-4 inhibitor.

However, a 2017 meta-analysis of randomized controlled trials found that GLP-1 receptor agonist use was safe and did not significantly raise the risk of pancreatitis.

With the mixed results found in these and other studies, more research is needed to verify the claim that some medications used to treat diabetes raise the risk 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 when 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 as well.

When to See a Doctor or Get Emergency Help

Call your doctor 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

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 important 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.

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Article Sources
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