Skip to main content

Advertisement

SpringerLink
Log in

Chronic Pancreatitis and Diabetes Mellitus

  • Pancreas (T Stevens, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Opinion statement

Patients with chronic pancreatitis should be screening at least annually for diabetes. Lifestyle modifications remain to be an important part of treatment for diabetic control. Unless contraindicated or not tolerated, metformin can be initiated and continued concurrently with other anti-diabetic agents or insulin. All anti-diabetic agents should be used based on their physiology and adverse effect profiles, along with the metabolic status of patients. Insulin therapy should be initiated without delay for any of the following: symptomatic or overt hyperglycemia, catabolic state secondary to uncontrolled diabetes, history of diabetic ketoacidosis, hospitalization or acute exacerbation of pancreatitis, or hyperglycemia that cannot be otherwise controlled. Dose adjustment should be done conservatively as these patients are more likely to be insulin sensitive and have loss of counter regulatory hormones. Insulin pump and continuous glucose monitoring should be considered early during therapy in selected patients. For patients undergoing total pancreatectomy or extensive partial pancreatectomy, evaluations to determine the eligibilities for islet cell autotransplantation should be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

DM:

Diabetes mellitus

CP:

Chronic pancreatitis

GIP:

Gastric inhibitory polypeptide

GLP:

Glucagon-like peptide

PP:

Pancreatic polypeptide

DKA:

Diabetic ketoacidosis

LKB1-AMPK:

Liver kinase B1-adenyl monophosphate protein-activated kinase

TZD:

Thiazolidinedione

SGLT2:

Sodium-glucose cotransporter 2

TP:

Total pancreatectomy

IAT:

Islet cell autotransplantation

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of major importance

  1. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003; 26 (Suppl 1): S5-20.

  2. American Diabetes Association. Standards of medical care in diabetes—2015. Diabetes Care. 2015;38 Suppl 1:S1–93.

    Google Scholar 

  3. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014; 37 (Suppl 1): S81-90.

  4. Corso G. Secondary forms of diabetes. In: Weir G, Kahn CR, editors. Joslin’s diabetes mellitus. New York: Lea & Febiger; 1994.

    Google Scholar 

  5. Abu-Bakare A et al. Tropical or malnutrition-related diabetes: a real syndrome? Lancet. 1986;1(8490):1135–8.

    CAS  PubMed  Google Scholar 

  6. Barman KK, Premalatha G, Mohan V. Tropical chronic pancreatitis. Postgrad Med J. 2003;79(937):606–15.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Ewald N et al. Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c). Diabetes Metab Res Rev. 2012;28(4):338–42.

    CAS  PubMed  Google Scholar 

  8. Rickels MR et al. Detection, evaluation and treatment of diabetes mellitus in chronic pancreatitis: recommendations from PancreasFest 2012. Pancreatology. 2013;13(4):336–42. Official published guideline making recommendations specifically for diabetes mellitus in chronic pancreatitis, including screening, establishing diagnosis, evaluation, treatment and future research directions.

    CAS  PubMed  Google Scholar 

  9. Malka D et al. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology. 2000;119(5):1324–32.

    CAS  PubMed  Google Scholar 

  10. Wang W et al. Occurrence of and risk factors for diabetes mellitus in Chinese patients with chronic pancreatitis. Pancreas. 2011;40(2):206–12.

    CAS  PubMed  Google Scholar 

  11. Gullo L et al. Diabetic retinopathy in chronic pancreatitis. Gastroenterology. 1990;98(6):1577–81.

    CAS  PubMed  Google Scholar 

  12. Levitt NS et al. The prevalence and severity of microvascular complications in pancreatic diabetes and IDDM. Diabetes Care. 1995;18(7):971–4.

    CAS  PubMed  Google Scholar 

  13. Larsen S et al. A comparative study of microvascular complications in patients with secondary and type 1 diabetes. Diabet Med. 1990;7(9):815–8.

    CAS  PubMed  Google Scholar 

  14. Ziegler O et al. Lower-extremity arterial disease in diabetes mellitus due to chronic pancreatitis. Diabete Metab. 1994;20(6):540–5.

    CAS  PubMed  Google Scholar 

  15. Kornhuber HH et al. The main cause of diabetes (type II): “normal” alcohol drinking]. Versicherungsmedizin. 1990;42(5):132. 134–42.

    CAS  PubMed  Google Scholar 

  16. Choudhuri G, Lakshmi CP, Goel A. Pancreatic diabetes. Trop Gastroenterol. 2009;30(2):71–5.

    PubMed  Google Scholar 

  17. Schrader H et al. Reduced pancreatic volume and beta-cell area in patients with chronic pancreatitis. Gastroenterology. 2009;136(2):513–22.

    PubMed  Google Scholar 

  18. Cui Y, Andersen DK. Pancreatogenic diabetes: special considerations for management. Pancreatology. 2011;11(3):279–94. Publication with comprehensive discussion about pathophysiology, potential complications and treatment options for chronic pancreatitis-associated diabetes mellitus.

    PubMed  Google Scholar 

  19. Nealon WH, Townsend Jr CM, Thompson JC. The time course of beta cell dysfunction in chronic ethanol-induced pancreatitis: a prospective analysis. Surgery. 1988;104(6):1074–9.

    CAS  PubMed  Google Scholar 

  20. Sidhu SS, Nundy S, Tandon RK. The effect of the modified puestow procedure on diabetes in patients with tropical chronic pancreatitis—a prospective study. Am J Gastroenterol. 2001;96(1):107–11.

    CAS  PubMed  Google Scholar 

  21. Kalk WJ et al. Selective loss of beta cell response to glucose in chronic pancreatitis. Horm Metab Res. 1974;6(2):95–8.

    CAS  PubMed  Google Scholar 

  22. Anderson MF et al. Plasma insulin in pancreatic disease. Gut. 1970;11(6):524–31.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Joffe BI et al. Insulin reserve in patients with chronic pancreatitis. Lancet. 1968;2(7574):890–2.

    CAS  PubMed  Google Scholar 

  24. Deckert T et al. Insulin secretion after tolbutamide and after secretin in patients with pancreatic diseases. Acta Med Scand. 1972;192(5):465–70.

    CAS  PubMed  Google Scholar 

  25. Sjoberg RJ, Kidd GS. Pancreatic diabetes mellitus. Diabetes Care. 1989;12(10):715–24.

    CAS  PubMed  Google Scholar 

  26. Goldstein JA et al. Reversal of in vitro hepatic insulin resistance in chronic pancreatitis by pancreatic polypeptide in the rat. Surgery. 1989;106(6):1128–32. discussion 1132–3.

    CAS  PubMed  Google Scholar 

  27. Nathan JD et al. Impaired hepatocyte glucose transport protein (GLUT2) internalization in chronic pancreatitis. Pancreas. 2001;22(2):172–8.

    CAS  PubMed  Google Scholar 

  28. Bonora E et al. Insulin and C-peptide plasma levels in patients with severe chronic pancreatitis and fasting normoglycemia. Dig Dis Sci. 1988;33(6):732–6.

    CAS  PubMed  Google Scholar 

  29. Nosadini R et al. Insulin sensitivity, binding, and kinetics in pancreatogenic and type I diabetes. Diabetes. 1982;31(4 Pt 1):346–55.

    CAS  PubMed  Google Scholar 

  30. Muggeo M et al. Insulin receptors on circulating blood cells from patients with pancreatogenic diabetes: a comparison with type I diabetes and normal subjects. J Endocrinol Investig. 1987;10(3):311–9.

    CAS  Google Scholar 

  31. Cavallini G et al. Diabetes in chronic alcoholic pancreatitis. Role of residual beta cell function and insulin resistance. Dig Dis Sci. 1993;38(3):497–501.

    CAS  PubMed  Google Scholar 

  32. Linde J, Nilsson LH, Barany FR. Diabetes and hypoglycemia in chronic pancreatitis. Scand J Gastroenterol. 1977;12(3):369–73.

    CAS  PubMed  Google Scholar 

  33. Persson I et al. Pancreatic-glucagon-like immunoreactivity after intravenous insulin in normals and chronic-pancreatitis patients. Acta Endocrinol (Copenh). 1971;67(2):401–4.

    CAS  Google Scholar 

  34. Kannan V, Nabarro JD, Cotton PB. Glucagon secretion in chronic pancreatitis. Horm Res. 1979;11(4):203–12.

    CAS  PubMed  Google Scholar 

  35. Aguilar-Parada E, Eisentraut AM, Unger RH. Pancreatic glucagon secretion in normal and diabetic subjects. Am J Med Sci. 1969;257(6):415–9.

    CAS  PubMed  Google Scholar 

  36. Besterman HS et al. Pancreatic and gastrointestinal hormones in chronic pancreatitis. Digestion. 1982;24(3):195–208.

    CAS  PubMed  Google Scholar 

  37. Larsen S et al. The effect of insulin withdrawal on intermediary metabolism in patients with diabetes secondary to chronic pancreatitis. Acta Endocrinol (Copenh). 1991;124(5):510–5.

    CAS  Google Scholar 

  38. Larsen S et al. Glucose counterregulation in diabetes secondary to chronic pancreatitis. Metabolism. 1990;39(2):138–43.

    CAS  PubMed  Google Scholar 

  39. Larsen S. Diabetes mellitus secondary to chronic pancreatitis. Dan Med Bull. 1993;40(2):153–62.

    CAS  PubMed  Google Scholar 

  40. Gyr K et al. Circulating somatostatin. Physiological regulator of pancreatic function? J Clin Invest. 1987;79(6):1595–600.

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Kloppel G et al. The endocrine pancreas in chronic pancreatitis. Immunocytochemical and ultrastructural studies. Virchows Arch A Pathol Anat Histol. 1978;377(2):157–74.

    CAS  PubMed  Google Scholar 

  42. Larsen S et al. Pancreatic hormone secretion in chronic pancreatitis without residual beta-cell function. Acta Endocrinol (Copenh). 1988;118(3):357–64.

    CAS  Google Scholar 

  43. Slaff JI, Wolfe MM, Toskes PP. Elevated fasting cholecystokinin levels in pancreatic exocrine impairment: evidence to support feedback regulation. J Lab Clin Med. 1985;105(3):282–5.

    CAS  PubMed  Google Scholar 

  44. Munkgaard S, Kelbaek H, Tronier B. Elevated plasma somatostatin in cirrhosis of the liver. N Engl J Med. 1981;304(23):1429–30.

    CAS  PubMed  Google Scholar 

  45. Hanafusa T et al. Impaired response of human pancreatic polypeptide to insulin-induced hypoglycemia in chronic pancreatitis without diabetes mellitus. Endocrinol Jpn. 1982;29(5):509–15.

    CAS  PubMed  Google Scholar 

  46. Seymour NE et al. Reversal of abnormal glucose production after pancreatic resection by pancreatic polypeptide administration in man. Surgery. 1988;104(2):119–29.

    CAS  PubMed  Google Scholar 

  47. Banerjee A, Onyuksel H. A novel peptide nanomedicine for treatment of pancreatogenic diabetes. Nanomedicine. 2013;9(6):722–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  48. Xu G et al. Exendin-4 stimulates both beta-cell replication and neogenesis, resulting in increased beta-cell mass and improved glucose tolerance in diabetic rats. Diabetes. 1999;48(12):2270–6.

    CAS  PubMed  Google Scholar 

  49. Gomez-Cerezo J et al. Postprandial glucose-dependent insulinotropic polypeptide and insulin responses in patients with chronic pancreatitis with and without secondary diabetes. Regul Pept. 1996;67(3):201–5.

    CAS  PubMed  Google Scholar 

  50. Knop FK et al. Increased postprandial responses of GLP-1 and GIP in patients with chronic pancreatitis and steatorrhea following pancreatic enzyme substitution. Am J Physiol Endocrinol Metab. 2007;292(1):E324–30.

    CAS  PubMed  Google Scholar 

  51. Hedetoft C et al. Effect of glucagon-like peptide 1(7–36)amide in insulin-treated patients with diabetes mellitus secondary to chronic pancreatitis. Pancreas. 2000;20(1):25–31.

    CAS  PubMed  Google Scholar 

  52. Ewald N et al. Determinants of exocrine pancreatic function as measured by fecal elastase-1 concentrations (FEC) in patients with diabetes mellitus. Eur J Med Res. 2009;14(3):118–22.

    PubMed  PubMed Central  Google Scholar 

  53. Vantyghem MC et al. Changes in serum amylase, lipase and leukocyte elastase during diabetic ketoacidosis and poorly controlled diabetes. Acta Diabetol. 1999;36(1–2):39–44.

    CAS  PubMed  Google Scholar 

  54. Ewald N, Hardt PD. Diagnosis and treatment of diabetes mellitus in chronic pancreatitis. World J Gastroenterol. 2013;19(42):7276–81. Publication proposing a specific criteria and other potential evaluating methods to establish the diagnosis of pancreatogenic diabetes.

    PubMed  PubMed Central  Google Scholar 

  55. Nyboe Andersen B et al. B cell function in patients with chronic pancreatitis and its relation to exocrine pancreatic function. Diabetologia. 1982;23(2):86–9.

    CAS  PubMed  Google Scholar 

  56. Teuscher AU et al. Successful islet autotransplantation in humans: functional insulin secretory reserve as an estimate of surviving islet cell mass. Diabetes. 1998;47(3):324–30.

    CAS  PubMed  Google Scholar 

  57. Bellin MD et al. Total pancreatectomy with islet autotransplantation: summary of a national institute of diabetes and digestive and kidney diseases workshop. Pancreas. 2014;43(8):1163–71.

    CAS  PubMed  PubMed Central  Google Scholar 

  58. Bellin MD et al. Total pancreatectomy and islet autotransplantation in chronic pancreatitis: recommendations from PancreasFest. Pancreatology. 2014;14(1):27–35.

    PubMed  Google Scholar 

  59. Frulloni L et al. Italian consensus guidelines for chronic pancreatitis. Dig Liver Dis. 2010;42 Suppl 6:S381–406.

    PubMed  Google Scholar 

  60. The diabetes control and complications trial (DCCT). Design and methodologic considerations for the feasibility phase. The DCCT research group. Diabetes. 1986; 35(5): 530–45.

  61. Prospective UK. Diabetes study (UKPDS). VIII. Study design, progress and performance. Diabetologia. 1991;34(12):877–90.

    Google Scholar 

  62. Terzin V et al. Improved glycemic control in pancreatic diabetes through intensive conservative insulin therapy. Pancreatology. 2012;12(2):100–3.

    CAS  PubMed  Google Scholar 

  63. Charbonneau A et al. Evidence of hepatic glucagon resistance associated with hepatic steatosis: reversal effect of training. Int J Sports Med. 2005;26(6):432–41.

    CAS  PubMed  Google Scholar 

  64. Lowenfels AB et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med. 1993;328(20):1433–7.

    CAS  PubMed  Google Scholar 

  65. Stolzenberg-Solomon RZ et al. Insulin, glucose, insulin resistance, and pancreatic cancer in male smokers. JAMA. 2005;294(22):2872–8.

    CAS  PubMed  Google Scholar 

  66. Maida A et al. Metformin regulates the incretin receptor axis via a pathway dependent on peroxisome proliferator-activated receptor-alpha in mice. Diabetologia. 2011;54(2):339–49.

    CAS  PubMed  Google Scholar 

  67. Zakikhani M et al. Metformin is an AMP kinase-dependent growth inhibitor for breast cancer cells. Cancer Res. 2006;66(21):10269–73.

    CAS  PubMed  Google Scholar 

  68. Shaw RJ. LKB1 and AMP-activated protein kinase control of mTOR signalling and growth. Acta Physiol (Oxf). 2009;196(1):65–80.

    CAS  Google Scholar 

  69. Kisfalvi K et al. Metformin disrupts crosstalk between G protein-coupled receptor and insulin receptor signaling systems and inhibits pancreatic cancer growth. Cancer Res. 2009;69(16):6539–45.

    CAS  PubMed  PubMed Central  Google Scholar 

  70. Schneider MB et al. Prevention of pancreatic cancer induction in hamsters by metformin. Gastroenterology. 2001;120(5):1263–70.

    CAS  PubMed  Google Scholar 

  71. Li D et al. Antidiabetic therapies affect risk of pancreatic cancer. Gastroenterology. 2009;137(2):482–8.

    PubMed  PubMed Central  Google Scholar 

  72. Sadeghi N et al. Metformin use is associated with better survival of diabetic patients with pancreatic cancer. Clin Cancer Res. 2012;18(10):2905–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  73. Cavaghan MK et al. Treatment with the oral antidiabetic agent troglitazone improves beta cell responses to glucose in subjects with impaired glucose tolerance. J Clin Invest. 1997;100(3):530–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  74. Dormandy J, Bhattacharya M, van Troostenburg de Bruyn AR. Safety and tolerability of pioglitazone in high-risk patients with type 2 diabetes: an overview of data from PROactive. Drug Saf. 2009;32(3):187–202.

    CAS  PubMed  Google Scholar 

  75. Kahn SE et al. Rosiglitazone-associated fractures in type 2 diabetes: an Analysis from a Diabetes Outcome Progression Trial (ADOPT). Diabetes Care. 2008;31(5):845–51.

    CAS  PubMed  Google Scholar 

  76. Meymeh RH, Wooltorton E. Diabetes drug pioglitazone (Actos): risk of fracture. CMAJ. 2007;177(7):723–4.

    PubMed  PubMed Central  Google Scholar 

  77. Matveyenko AV et al. Beneficial endocrine but adverse exocrine effects of sitagliptin in the human islet amyloid polypeptide transgenic rat model of type 2 diabetes: interactions with metformin. Diabetes. 2009;58(7):1604–15.

    CAS  PubMed  PubMed Central  Google Scholar 

  78. Singh S et al. Glucagonlike peptide 1-based therapies and risk of hospitalization for acute pancreatitis in type 2 diabetes mellitus: a population-based matched case–control study. JAMA Intern Med. 2013;173(7):534–9.

    CAS  PubMed  Google Scholar 

  79. Fujita Y, Inagaki N. Renal sodium glucose cotransporter 2 inhibitors as a novel therapeutic approach to treatment of type 2 diabetes: clinical data and mechanism of action. J Diabetes Investig. 2014;5(3):265–75.

    CAS  PubMed  PubMed Central  Google Scholar 

  80. Riser Taylor S, Harris KB. The clinical efficacy and safety of sodium glucose cotransporter-2 inhibitors in adults with type 2 diabetes mellitus. Pharmacotherapy. 2013;33(9):984–99.

    CAS  PubMed  Google Scholar 

  81. Casneuf VF et al. Expression of SGLT1, Bcl-2 and p53 in primary pancreatic cancer related to survival. Cancer Invest. 2008;26(8):852–9.

    CAS  PubMed  Google Scholar 

  82. Moran A et al. Clinical care guidelines for cystic fibrosis-related diabetes: a position statement of the American Diabetes Association and a clinical practice guideline of the Cystic Fibrosis Foundation, endorsed by the Pediatric Endocrine Society. Diabetes Care. 2010;33(12):2697–708.

    PubMed  PubMed Central  Google Scholar 

  83. Ito T et al. Epidemiological study of pancreatic diabetes in Japan in 2005: a nationwide study. Pancreas. 2010;39(6):829–35.

    PubMed  Google Scholar 

  84. Russell SJ et al. Outpatient glycemic control with a bionic pancreas in type 1 diabetes. N Engl J Med. 2014;371(4):313–25.

    PubMed  PubMed Central  Google Scholar 

  85. Trajkovic-Arsic M, Kalideris E, Siveke JT. The role of insulin and IGF system in pancreatic cancer. J Mol Endocrinol. 2013;50(3):R67–74.

    CAS  PubMed  Google Scholar 

  86. Bonelli L et al. Exocrine pancreatic cancer, cigarette smoking, and diabetes mellitus: a case–control study in northern Italy. Pancreas. 2003;27(2):143–9.

    PubMed  Google Scholar 

  87. Choi EK et al. The long-term follow-up results after steroid treatment in patients with autoimmune chronic pancreatitis. Korean J Gastroenterol. 2006;47(6):440–8.

    PubMed  Google Scholar 

  88. Tanaka S et al. Corticosteroid-responsive diabetes mellitus associated with autoimmune pancreatitis. Lancet. 2000;356(9233):910–1.

    CAS  PubMed  Google Scholar 

  89. Brunicardi FC et al. Pancreatic polypeptide administration improves abnormal glucose metabolism in patients with chronic pancreatitis. J Clin Endocrinol Metab. 1996;81(10):3566–72.

    CAS  PubMed  Google Scholar 

  90. Rabiee A et al. Pancreatic polypeptide administration enhances insulin sensitivity and reduces the insulin requirement of patients on insulin pump therapy. J Diabetes Sci Technol. 2011;5(6):1521–8.

    PubMed  PubMed Central  Google Scholar 

  91. Hammel P, Malca D, Levy P, et al. Influence of elective pancreatic surgery on the occurrence of diabetes in patients with chronic pancreatitis. Gatroenterology. 1996;110:A396. abstract.

    Google Scholar 

  92. Brand B et al. Prospective evaluation of morphology, function, and quality of life after extracorporeal shockwave lithotripsy and endoscopic treatment of chronic calcific pancreatitis. Am J Gastroenterol. 2000;95(12):3428–38.

    CAS  PubMed  Google Scholar 

  93. Adams DB, Ford MC, Anderson MC. Outcome after lateral pancreaticojejunostomy for chronic pancreatitis. Ann Surg. 1994;219(5):481–7. discussion 487–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  94. Aspelund G et al. Improved outcomes for benign disease with limited pancreatic head resection. J Gastrointest Surg. 2005;9(3):400–9.

    PubMed  Google Scholar 

  95. Mehrabi A et al. Expanding the indications of pancreas transplantation alone. Pancreas. 2014;43(8):1190–3.

    CAS  PubMed  Google Scholar 

  96. Dong M et al. Systematic review and meta-analysis: islet autotransplantation after pancreatectomy for minimizing diabetes. Clin Endocrinol (Oxf). 2011;75(6):771–9.

    Google Scholar 

  97. Sutherland DE et al. Total pancreatectomy and islet autotransplantation for chronic pancreatitis. J Am Coll Surg. 2012;214(4):409–24. discussion 424–6.

    PubMed  PubMed Central  Google Scholar 

  98. Bellin MD et al. Islet autotransplantation to preserve beta cell mass in selected patients with chronic pancreatitis and diabetes mellitus undergoing total pancreatectomy. Pancreas. 2013;42(2):317–21.

    PubMed  PubMed Central  Google Scholar 

  99. Gruessner RW et al. Pancreas allotransplants in patients with a previous total pancreatectomy for chronic pancreatitis. J Am Coll Surg. 2008;206(3):458–65.

    PubMed  Google Scholar 

  100. Sato Y et al. Heterotopic pancreas autotransplantation with spleen for uncontrollable hemorrhagic pseudocyst and disabling pain in chronic pancreatitis. Hepatogastroenterology. 2013;60(123):425–7.

    PubMed  Google Scholar 

  101. Ricordi C et al. Outcome of human islet isolation and allotransplantation in 20 consecutive cases. Diabetes Nutr Metab. 1992;5 Suppl 1:193–8.

    PubMed  Google Scholar 

  102. Shalimov A A, et al. [Experience in xenografts of pancreatic islet cell cultures after surgical treatment of chronic pancreatitis]. Klin Khir, 1990(11): 1–2.

  103. Rajesh G et al. Diet, nutrient deficiency and chronic pancreatitis. Trop Gastroenterol. 2013;34(2):68–73.

    PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Yu Kuei Lin, Philip C. Johnston, Karla Arce, and Betul A. Hatipoglu declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic Foundation, 9500 Euclid Avenue Desk F20, Cleveland, OH, 44195, USA

    Yu Kuei Lin MD, Karla Arce MD & Betul A. Hatipoglu MD

  2. Regional Center for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, Northern Ireland, UK

    Philip C. Johnston MD

Authors
  1. Yu Kuei Lin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Philip C. Johnston MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karla Arce MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Betul A. Hatipoglu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Betul A. Hatipoglu MD.

Additional information

This article is part of the Topical Collection on Pancreas

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, Y.K., Johnston, P.C., Arce, K. et al. Chronic Pancreatitis and Diabetes Mellitus. Curr Treat Options Gastro 13, 319–331 (2015). https://doi.org/10.1007/s11938-015-0055-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11938-015-0055-x

Keywords

Search

Navigation