In their 2024 Standards of Care in Diabetes, the American Diabetes Association (ADA state that “Diabetes is classified conventionally into several clinical categories, although these are being reconsidered based on genetic, metabolomic, and other characteristics and pathophysiology”.
They expand on this when describing diabetes other than type 1, type 2 and gestational diabetes:
- specific types of diabetes due to other causes, e.g., monogenic diabetes syndromes (such as neonatal diabetes and maturity-onset diabetes of the young),
- diseases of the exocrine pancreas (such as cystic fibrosis and pancreatitis), and
- drug- or chemical-induced diabetes (such as with glucocorticoid use, in the treatment of people with HIV, or after organ transplantation).
It can be appreciated from clinical practice that the classification of diabetes type is not always straightforward at presentation, and that misdiagnosis is common. In fact, the ADA recognize that over 40% of those developing type 1 diabetes after age 30 years may initially be treated as having type 2 diabetes, and that individuals with maturity-onset diabetes of the young [MODY] may be misdiagnosed as having type 1 diabetes.
This session will cover the clinically relevant aspect of pancreatic enzyme insufficiency (PEI) in a relatively uncommon form of diabetes – cystic fibrosis related diabetes (CFRD). We will also cover PEI screening and management in the non-cystic fibrosis setting.
