I'm sorry @janeliz but you are not quite accurate. My type 3C is not caused by either acute or chronic pancreatitis, type 3C is not simply as a result of loss of pancreatic function, it is as a result of severe damage, death or removal of the organ thus diminishing or destroying the function of the alpha cells as well as the beta cells which are effected in type 1. The management if 3C also has to consider the extent of involvement of the exocrine systrm and the ability to digest foods. There are many degrees of 'severity' dependant on the extent of the damage and this means that it has to be treated in some cases very differently to type 1. Having no living pancreas, I am a 'severe' type 3C. My diabetes is brittle, with sudden hypos which bear no correlation to such things as food, insulin, exercise, illness etc so are frequent and unpredictable. My insulin regime is affected by my malabsorption of carbs, protein and fats so carb counting is impossible and I have to regulate my blood sugars by a process of basal/bolus and correction as the norm which would never be recommended for a type 1. It is very different. Xx
A C-PEP on its own is not usually used to diagnose anything accurately on its own as it basically shows how much insulin is or isn't being produced. The exception is when there is no or very little insulin produced which is considered an indicator of type 1. In type 3C it is not always that definitive, because of the cause of 3C which is dependant upon the extent of the damage or destruction of the pancreas. I often see many diabetic posts say that their pancreas is dead, with every respect to them, that is not an accurate description. In type 1 there is damage/distruction to the beta cells and not necessarily to the other functions of the organ. (Apologies to all type 1s for over simplifying!!) The pancreas has other functions as well as the production of insulin and in 3C there is whole organ involvement. This means that the exocrine involvement would cause problems with the digestion and absorbsion of food, initially fats, then carbs and proteins. Often the exocrine deficiency is evident before the onset of diabetes. In my case I had severe exocrine defiency for over 10 years before the first evidence if diabetes, and nearly 15 years before I became insulin dependant. However during that time I was hospitalised fairly regularly with malnourishment, and required nutrition support via a tube ( but not everyone is as severe as me!). So basically if there is sufficient pancreatic damage you will know because it will be evident on MRI, endoscopy, you may have had some jaundice on onset, it is likely that LFT blood will be abnormal, there will be problematic weight loss, chronic sickness/diahorrea. Personally I would say you can not have type 3C diabetes without knowing it because it is always accompanied by a serious pancreatic condition that could not go untreated (it is life threatening) - @Shar67 would you agree??
