Conclusions

Pancreatogenic diabetes mellitus is an underrecognized and frequently misclassified form of secondary diabetes that develops in the setting of chronic pancreatic disease and pancreatic resection. This case highlights the importance of maintaining a high index of suspicion for T3cDM in patients with a history of chronic pancreatitis or partial pancreatectomy who present with severe hyperglycemia and low C-peptide levels suggestive of impaired endogenous insulin secretion. Early recognition is essential because the pathophysiology and management of T3cDM differ substantially from those of type 2 diabetes mellitus and often require early insulin therapy. Greater awareness of T3cDM among clinicians may improve diagnostic accuracy, facilitate timely initiation of appropriate treatment, and ultimately reduce the risk of long-term metabolic complications.