Chronic pancreatitis with increased appetite and thirst may indicate secondary diabetes. What explains the cause?

• A. Ingestion of foods high in sugar
• B. Dysfunction of the pancreatic islet cells
• C. Renal failure
• D. Inability for the liver to reabsorb serum glucose

Answer: (B)

The key concept is that secondary diabetes from chronic pancreatitis results from destruction or dysfunction of the pancreatic islet cells, especially the insulin-producing beta cells. When these cells are damaged, insulin production falls, leading to elevated blood glucose. Without sufficient insulin, glucose stays in the bloodstream and cells don’t get the fuel they need, which triggers increased appetite (polyphagia) as the body signals hunger despite high glucose, and increased thirst (polydipsia) due to osmotic diuresis from the high glucose levels. So the underlying cause is dysfunction of the pancreatic islet cells causing insulin deficiency.

Dietary sugar intake isn’t what initiates this chronic endocrine problem, and renal failure doesn’t directly explain the destruction or impairment of the islet cells. The liver’s ability to reabsorb glucose isn’t the mechanism here, since the issue is insulin production and action stemming from pancreatic damage.