For last week’s practice question, we quizzed participants on RT forgetting their insulin, and what would be the best response. 62.93% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
JR was recently diagnosed with type 2 diabetes, but based on their history of pancreatitis, you suspect JR actually has Diabetes Type 3c.
Which of the following symptoms match a diagnosis of Diabetes Type 3c?
- Fatty stools and insulin sensitivity.
- Frequent urination and insulin resistance.
- Neuropathy and unexplained weight gain.
- Family history of diabetes type 3c and polyphagia.
Getting to the Best Answer
Answer A is correct: 62.93% chose this answer, “Fatty stools and insulin sensitivity.” Steatorrhea, or fatty stools, results from poor fat digestion due to insufficient pancreatic enzymes—a key feature of type 3c diabetes, with it’s hallmark exocrine enzyme insufficiency. People with diabetes type 3c, can also be very insulin sensitive, since they don’t have the insulin resistance associated with type 2 diabetes. In addition to diabetes medications, they may benefit from pancreatic enzyme replacement therapy (PERT) to improve absorption of fatty foods and decrease steatorrhea.
Answer B is incorrect: 15.47% chose this answer, “Frequent urination and insulin resistance.” Frequent urination and insulin resistance is associated with type 2 diabetes. With type 3c, since many of the beta cells are destroyed due to trauma not genetics, these individuals may have polyuria from hyperglycemia, but they are not usually insulin resistant, just deficient.
Answer C is incorrect: 7.47% chose this answer, “Neuropathy and unexplained weight gain.” They may get neuropathy if their blood glucose is elevated for a long period of time, but that is not part of the differential. People with type 3c usually experience weight loss due to the lack of pancreatic enzymes that help with nutrient absorption.
Answer D is incorrect: 14.13% chose this answer, “Family history of diabetes type 3c and polyphagia.” Type 3c diabetes is not passed on through genes, it is due to exocrine damage to the pancreas which can lead to destruction of beta cells. Most common causes of diabetes type 3c include pancreatitis, cystic fibrosis, pancreatic cancer, and hemochromatosis. Some people could experience extreme hunger if their glucose levels are elevated for an extended period of time.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Learn more about Diabetes Type 3c in our “From the Gut to the Butt Webinar”
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