Diagnosis and treatment of diabetes mellitus in chronic pancreatitis

Table 2 Proposed diagnostic criteria for type 3c diabetes mellitus

Major criteria (must be present)

Presence of exocrine pancreatic insufficiency (monoclonal fecal elas tase-1 test or direct function tests)

Pathological pancreatic imaging (endoscopic ultrasound, MRI, CT)

Absence of type 1 diabetes mellitus associated autoimmune markers

Minor criteria

Absent pancreatic polypeptide secretion

Impaired incretin secretion (e.g., GLP-1)

No excessive insulin resistance (e.g., HOMA-IR)

Impaired beta cell function (e.g., HOMA-B, C-Peptide/glucose-ratio)

Low serum levels of lipid soluble vitamins (A, D, E and K)

MRI: Magnetic resonance imaging; CT: Computed tomography; GLP-1: Glucagon-like peptide-1; HOMA-IR: Homeostasis model assessment of insulin resistance; HOMA-B: Homeostasis model assessment of beta-cell.