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Secondary diabetes is diabetes that occurs as a result of another disease or factor. Secondary diabetes is uncommon. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that it accounts for 1 to 2 percent of all diabetes cases, and the National Diabetes Education Program puts that figure at 1 to 5 percent.

Diabetes is a disorder in the body’s ability to use a hormone called insulin to process glucose (blood sugar) for energy. Type 1 diabetes is an autoimmune disease that destroys the insulin-making cells of the pancreas. Type 2 is a metabolic disorder, generally involving genetic and behavioral factors, excess weight and insulin resistance. Gestational diabetes is also a metabolic condition but is temporary and related to hormonal changes associated with pregnancy.

Secondary diabetes is sometimes defined as covering all cases that cannot be classified as type 1, type 2 or gestational. However, conditions that are often considered separately from secondary diabetes include latent autoimmune diabetes of the young (LADA), maturity-onset diabetes of the young (MODY), autoimmune polyglandular syndrome and Wolfram syndrome.

Secondary diabetes can be related to a wide variety of disorders and other conditions. For example, pancreatitis can damage the insulin-producing beta cells. Secondary diabetes may also occur in conjunction with many other diseases, such as cystic fibrosis, as well as certain medications or other medical treatments.

Except for gestational diabetes, most cases of diabetes are chronic. However, some forms of secondary diabetes may be a temporary condition that goes away when the condition causing the diabetes is treated. For example, if certain medications are causing a patient’s diabetes, ceasing use of those medications could return glucose levels to normal. However, no medication should be stopped or started without first consulting a physician. Other cases of secondary diabetes, such as those resulting from total pancreatectomy, will last the rest of the patient’s life.

Sometimes it is difficult or impossible to distinguish secondary from primary diabetes, especially cases involving insulin resistance, which would typically be considered type 2 diabetes. For example:

• Some research has linked exposure to certain plastics to insulin resistance, but if this did lead to secondary diabetes in a person it would likely go undetected, and other factors would typically contribute to the insulin resistance.
  
  
• An asthma patient may be obese, have a family history of type 2 diabetes and have been using oral corticosteroids for years. The excess weight, family history and medication could all contribute to diabetes, which in this patient would likely be diagnosed as type 2.
  
  
• Conditions including fatty liver disease and alcohol abuse may contribute to diabetes, but these cases too are often considered to be type 2.

In addition, diabetes that is related to autoimmune diseases such as celiac disease may be viewed as a form of type 1 diabetes.