Fibrocalculous Pancreatic Diabetes: (FCPD)
A most common form of diabetes worldwide is Type 1 and Type 2 diabetes. Fibrocalculous pancreatic diabetes (FCPD) is a unique form of diabetes, associated with both endocrine and exocrine diseases of the pancreas. The pre-diabetic phase of the disease is known as tropical chronic pancreatitis (TCP). Both diseases are classified as a secondary form of diabetes called pancreatic diabetes. These subjects are overlapped with idiopathic, non-alcoholic pancreatitis. Dr. Suganthi Kumaran and colleagues published a paper under the title “Fibrocalculous Pancreatic Diabetes: (FCPD)” in the Journal of Diabetes and Its Complications. The summary of this paper is given below:
Objective:
To elaborate on the etiopathogenesis, diagnosis, and management of TCP and FCPD.
Method:
The information was developed from the currently available evidence and scientific and medical knowledge on the topic of interest.
Findings:
FCPD is a unique form of diabetes occurring in tropical regions, secondary to chronic non-alcoholic calcific pancreatitis in young individuals. This disease has heterogeneous nature that is reflected in the clinical, biochemical, and histopathological features. Causative measures which were proposed earlier such as protein malnutrition, anti-oxidant theories, and cassava ingestion have been disproved. Lately, the genetic mutation with the SPINK1 N34S gene has been found to be linked with FCPD.
The typical patient for FCPD was most of the time a lean adolescent or young individual from a low socio-economic status presenting with complaints of repeated attacks of abdominal pain and steatorrhea. On the other hand, older people with higher BMI and without stigmata of malnutrition are also at high risk. Ultrasound abdomen showing pancreatic calculi and CT scan show pancreatic ductal dilatation is used for diagnosis. Investigators highlight the importance of appropriate pancreatic enzyme replacement, and surveillance of pancreatic cancer. Lifestyle modifications, oral drugs, or insulin can help manage hyperglycemia. Screening for diabetes-related complications must be routinely conducted.
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