Oral Anti-Hyperglycaemic Therapies Effective for Management of diabetes secondary to pancreatic condition: Study
Oral anti-hyperglycaemic therapies improve the glycaemic control in type 3c diabetes individuals as a consequence of pancreatic diseases. A recent study was published in the journal Diabetes Obesity and Metabolism conducted by Rhian Hopkins and colleagues. Type 3c diabetes comes from acute or chronic pancreatitis, pancreatic cancer, and haemochromatosis.
Data were analyzed from 7084 individuals with type 3c diabetes initiating oral therapies without concomitant insulin use and compared their outcomes with 97,227 matched T2D controls. Using UK hospital-linked primary care records (Clinical Practice Research Datalink, 2004–2020), researchers identified 7084 individuals diagnosed with type 3c diabetes following a pancreatic condition, such as acute pancreatitis, chronic pancreatitis, pancreatic cancer, or haemochromatosis. Participants were grouped based on the presence (n=1167) or absence (n=5917) of pancreatic exocrine insufficiency (PEI).
Participants initiated oral anti-hyperglycaemic therapies, including:
Metformin
• Sulphonylureas
• SGLT2-inhibitors
• DPP4-inhibitors
• Thiazolidinediones
The outcomes reviewed were 12-month HbA1c decrease, changes in weight and 6 months treatment discontinuance rates. It was cross-checked with an unmatched control group of 97,227 clients with T2D.
Key findings:
HbA1c Drop:
• Individuals with type 3c diabetes without PEI experienced a mean HbA1c reduction of 12.2 mmol/mol (95% CI: 12.0–12.4).
• Those with PEI had a lesser reduction of 9.4 mmol/mol (95% CI: 8.9–10.0).
Compared with T2D controls:
• Reduction in HbA1c was comparable between patients without PEI (0.7 mmol/mol difference; 95% CI: 0.4–1.0).
• Patients with PEI had a reduced reduction of 3.5 mmol/mol (95% CI: 2.9–4.1).
Treatment Cessation
• Odds of treatment cessation were non-significantly different for type 3c diabetes without PEI compared to T2D controls (Odds Ratio [OR]: 1.08, 95% CI: 0.98–1.19).
• Patients with PEI had higher odds of treatment cessation compared to T2D controls (OR: 2.03, 95% CI: 1.73–2.36)
Weight Change
• Weight changes in type 3c diabetes were similar to those in T2D across all groups and therapies.
Oral anti-hyperglycaemic therapies are very effective in managing type 3c diabetes, especially in those patients without PEI. It is important that these therapies should be considered a crucial part of the treatment plan, while patients with PEI need close monitoring to overcome the specific challenges associated with achieving optimal glycaemic control.
Reference:
Hopkins, R., Young, K. G., Thomas, N. J., Jones, A. G., Hattersley, A. T., Shields, B. M., Dennis, J. M., McGovern, A. P., & the MASTERMIND consortium. (2025). Treatment outcomes with oral anti‐hyperglycaemic therapies in people with diabetes secondary to a pancreatic condition (type 3c diabetes): A population‐based cohort study. Diabetes, Obesity & Metabolism. https://doi.org/10.1111/dom.16163
