A new pancreatic cancer drug is changing survival odds — and Type 3c diabetes will follow

What the trial showed

A clinical trial reported by The Guardian on 31 May 2026 found that daraxonrasib, a once-daily oral pill, doubles survival time for people with pancreatic cancer. Pancreatic cancer has historically had one of the lowest five-year survival rates of any cancer. If this drug delivers at scale, far more patients will survive long enough to live with the downstream consequences of pancreatic disease — including diabetes.

Why pancreatic cancer leads to diabetes

The pancreas does two distinct jobs. The endocrine pancreas produces insulin and glucagon, the hormones that regulate blood sugar. The exocrine pancreas produces digestive enzymes that break down fat and protein in the gut.

Pancreatic cancer, and the surgery used to treat it, damages or removes pancreatic tissue. When that happens, both functions are impaired:

• Insulin production falls, because the beta cells that produce it are gone or damaged.
• Glucagon production also falls, because the alpha cells are in the same tissue.
• Enzyme production drops, causing fat and protein malabsorption — a condition called exocrine pancreatic insufficiency (EPI), which is treated with pancreatic enzyme replacement therapy (PERT) such as Creon.

The result is Type 3c diabetes, also called pancreatogenic diabetes. It is not Type 1 (autoimmune). It is not Type 2 (insulin resistance). It is a distinct category with its own clinical profile and its own management challenges.

Type 3c is systematically misdiagnosed

Research suggests that around one in twenty people with diabetes in Western countries has Type 3c, but it is frequently misclassified as Type 2 at diagnosis. This matters because the standard management advice for Type 2 does not fit.

People with Type 3c often:

• Become insulin-dependent faster than Type 2 patients, because they cannot compensate with remaining beta cells.
• Experience unpredictable blood sugar swings in both directions, because the protective glucagon response is also impaired — hypoglycaemia is harder to self-correct.
• Need to manage fat intake carefully, because EPI means high-fat meals are not absorbed normally, which changes both the glucose response and the need for PERT dosing.
• Face nutritional deficiencies from malabsorption, adding fatigue to an already difficult picture.

A person who survives pancreatic cancer and is told they have "Type 2 diabetes" may spend years following advice that does not apply to their physiology.

What this means as survival rates improve

If drugs like daraxonrasib move pancreatic cancer from a largely terminal diagnosis to a manageable long-term condition for a meaningful proportion of patients, the Type 3c population will grow. People who previously had months will have years — years in which glucose management, enzyme dosing, and nutritional tracking become everyday concerns rather than afterthoughts.

This is a population that is currently underserved. Most diabetes apps are built around Type 1 or Type 2. They assume intact glucagon responses. They do not have fields for PERT dosing. They do not flag that a high-fat meal might produce a delayed, unpredictable glucose spike three hours later because digestion was slow.

GlycoTrace was designed with Type 3c in mind

GlycoTrace is a glucose tracking app built for people who need more than the standard Type 1 or Type 2 framework. It tracks glucose, meals, insulin, and exercise together, so users can see correlations across the day rather than isolated readings.

For people with Type 3c, that means:

• Logging meals with fat and protein content, not just carbs, and seeing how those meals affect glucose over time.
• Correlating glucose trends with activity and timing, which matters more when glucagon responses are unreliable.
• Building a personal record to share with a specialist — useful in a condition that many GPs have rarely seen.

If you or someone you know has had pancreatic disease

Type 3c is underdiagnosed but manageable when it is properly identified. If you have had pancreatic cancer, pancreatitis, or pancreatic surgery, and you are experiencing blood sugar problems, it is worth asking your endocrinologist specifically about Type 3c rather than accepting a default Type 2 classification.

Guts UK is the leading UK charity for pancreatic conditions and a useful starting point for further reading. Our plain-English guide to Type 3c diabetes explains the condition in full.