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Pancreatic exocrine function in patients with diabetes.
E Larger1, M F Philippe, L Barbot-Trystram
1Laboratoire de coprologie, Hôtpital de la Pitié-Salpétrière, APHP, Paris, France. etienne.larger@htd.aphp.fr
Diabetic Medicine : a Journal of the British Diabetic Association
|January 26, 2012
Summary
Pancreatic exocrine failure is common in diabetes. Factors linked to this failure differ between Type 1 and Type 2 diabetes, suggesting distinct underlying mechanisms for each type.
Area of Science:
- Endocrinology and Metabolism
- Gastroenterology
- Diabetology
Background:
- Decreased pancreatic exocrine function is a frequent complication in patients with diabetes mellitus.
- Understanding the clinical correlates of pancreatic exocrine failure is crucial for patient management.
Purpose of the Study:
- To investigate the clinical factors associated with pancreatic exocrine failure in patients with diabetes.
- To differentiate these associations between Type 1 diabetes and Type 2 diabetes.
Main Methods:
- Assessed exocrine function using elastase-1 concentration and chymotrypsin activity in 667 diabetic patients.
- Analyzed data separately for patients with Type 1 diabetes (n=195) and Type 2 diabetes (n=472).
- Grouped patients based on normal or altered levels of both pancreatic function markers.
Main Results:
- Prevalence of decreased elastase-1 was 23% and chymotrypsin was 26%; 15% had both markers below threshold.
- In Type 1 diabetes, exocrine failure correlated with diabetes duration and GAD antibodies, not BMI or complications.
- In Type 2 diabetes, exocrine failure correlated with BMI, insulin use, and vascular disease, but not duration.
Conclusions:
- Clinical correlates of pancreatic exocrine failure significantly differ between Type 1 and Type 2 diabetes.
- In Type 2 diabetes, the association with BMI and vascular disease suggests a potential role for pancreatic arteriopathy.
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