discoveries magazine

Could a Third Form of Diabetes Exist?

When Mark Goodarzi, MD, PhD, first heard the phrase “Type 3c diabetes mellitus,” he was dubious. “Type 3c is not an official designation,” says the director of Endocrinology, Diabetes, and Metabolism at Cedars-Sinai.

But today, Goodarzi leads a multisite research group studying Type 3c that is funded by a National Institutes of Health grant.

Type 3c refers to a secondary form of diabetes triggered by pancreatic diseases like pancreatitis (inflammation of the organ) or pancreatic cancer. The term pops up in research papers but is seldom heard in doctors’ offices.

Regardless of the condition’s name, Goodarzi and co-principal investigator Stephen Pandol, MD, director of Basic and Translational Pancreas Research at Cedars-Sinai, are trying to answer the question: Is this truly a distinct form of diabetes, or is it another manifestation of Type 2?

“I’m a diabetes genetics person, while Stephen is the local pancreas guy,” Goodarzi says. “I would not have considered pursuing this project without him.”

The pancreas is a unique organ in that it has both a hormonal and a digestive function. Diabetes is caused by poor insulin production, whereas pancreatitis is linked to the digestive enzymes the organ produces. When a patient presents with diabetes, physicians rarely consider pancreatitis as a cause, looking to hormone-related processes instead.

“But these functions are not independent,” Goodarzi says. “If people are getting misdiagnosed with Type 2 when the underlying cause is pancreatitis, we want to correct that.” In an upcoming clinical trial, Goodarzi, Pandol, and their collaborators will try to establish ways to distinguish Type 3c from Type 2 diabetes.

The work will be an important step toward settling the Type 3c debate and “a great example of the value of building new collaborations with investigators with complementary expertise,” Goodarzi says.