Abstract
Pancreatic diabetes mellitus (DM) is a type of secondary diabetes associated with exocrine pancreatic diseases such as chronic pancreatitis. Chronic pancreatitis generally results in the destruction and reduction of pancreatic endocrine and exocrine function. In patients with pancreatic DM frequently, this frequently leads to malnutrition resulting from maldigestion and malabsorption, as a result of insufficiencies in pancreatic digestive enzymes, and show unstable glycemic control and prolonged hypoglycemia stemming from insufficiencies in the synthesis and secretion of both insulin and glucagon. Intensive insulin therapy can be instituted in order to achieve stable glycemic control in patients with pancreatic DM. Recently, incretin-based therapy has been used for type 2 DM. However, at this point, there is insufficient evidence to support the safety and efficacy of incretin-based therapy for patients with DM secondary to chronic pancreatitis. Based on the recommendations of the Japanese guidelines for the management of chronic pancreatitis 2015, the use of incretin-based therapy for patients with DM secondary to chronic pancreatitis should only be considered when the benefits outweigh the risks.