Diabetes mellitus type 2 met atypisch beloop

Wees bedacht op pancreascarcinoom
Klinische les
Roelf Holtrop en Wouter M. Creyghton

Dames en Heren,

Een pancreascarcinoom is een relatief zeldzame aandoening, vergeleken met diabetes mellitus type 2. Soms wordt de diagnose ‘pancreascarcinoom’ voorafgegaan door diabetes mellitus. Hoe kom je erachter bij wie diabetes mellitus een voorbode is van deze sluipende vorm van kanker?

Atypical presentation of type 2 diabetes mellitus: be aware of pancreatic carcinoma

An atypical course of type 2 diabetes should prompt a reconsideration of the diagnosis. First of all, consider the possibility of autoimmune diabetes (type 1 diabetes). Also bear in mind that an underlying condition, such as pancreatic carcinoma, could be the main cause of or an aggravating factor for the diabetes. Characteristics of diabetes mellitus that differ from a typical presentation of newly diagnosed type 2 diabetes are: (a) loss of body weight at the time of the diabetes mellitus diagnosis followed by continued weight loss despite diabetes treatment, (b) lack of metabolic syndrome characteristics (for example, hypertension, dyslipidaemia and obesity) and (c) sudden development of poor glycaemic control without other contributing factors.

Conflict of interest and financial support: none declared.