Type 3c Diabetes Mellitus: Epidemiology, Diagnosis, Management, and Research Imperatives With Insights From the United Arab Emirates and Global Contexts

Type 3c diabetes mellitus (T3cDM), also known as pancreatogenic diabetes, is a form of secondary diabetes resulting from pancreatic disease and is frequently misclassified as type 2 DM (type 2 DM). A narrative review of peer-reviewed literature from international databases was conducted, with emphasis on the epidemiology, clinical differences, diagnostic complexities, and management of T3cDM, with a specific focus on the United Arab Emirates (UAE) and global contexts. T3cDM accounts for a notable proportion of global diabetes cases, yet it is underreported due to a lack of dedicated registries and frequent misclassification as type 2 diabetes. The UAE has one of the highest diabetes prevalence rates worldwide, yet T3cDM remains undercaptured. Unlike type 1 DM (T1DM) and T2DM, T3cDM is characterized by both endocrine and exocrine pancreatic insufficiency (EPI). The diagnosis requires evidence of pancreatic pathology, absent autoimmunity, and exocrine dysfunction. Management includes insulin therapy, pancreatic enzyme replacement therapy (PERT), and nutritional supplementation; recent advances include the role of incretin therapies, improved enzyme preparations, and regenerative medicines. Emerging approaches also include metabolomics for prediction and fecal microbiota transplantation. Increasing awareness, dedicating regional registries, and implementing multidisciplinary management strategies are urgently needed in the UAE and globally.