A rare form of pancreatic diabetes complicated by portal venous thrombosis: A 25-year follow-up.

Fibrocalculous pancreatic diabetes (FCPD) is an uncommon type of diabetes mellitus, so called tropical diabetes, due to chronic calcific non-alcoholic pancreatitis. This type of diabetes is associated to several particularities based on glycemic control and the occurrence of degenerative and metabolic complications, in addition to chronic pancreatitis complications such us venous thrombosis. We report here a rare case of a young North-African patient with long standing FCPD followed for 25 years and complicated by portal venous thrombosis. This case presentation highlights how important is to suspect fibrocalculous pancreatic diabetes especially in the presence of chronic abdominal pain. The follow-up of such patients should be focused not only on the clinical and biological markers of diabetes, but also on pancreatitis complications.

[About age of diabetes]

Diabetes in the elderly is increasing significantly in medical practice. This retrospective study is about 261 patients over 60 years of age at the diagnosis of diabetes. The main conditions of diagnosis were fortuitous discovery [50, 9%], cardinal signs [23, 3%] and complication in 19, 2% of the cases. Systematic screening was rare [6, 9%]. A microangiopathy was seen in 27, 6% of the cases corresponding to an undetected diabetes and vascular lesions were found in 15, 7% of the cases. The majority of patients had type 2 diabetes [95, 8%] and 8,896 of them were already requiring insulin therapy. 44.4% of the patients were also treated for other conditions and 19.9% had a handicap. Our results suggest the need for an early screening and for a complete clinical and etiologic evaluation when diabetes is found in the elderly