B cell function in patients with chronic pancreatitis and its relation to exocrine pancreatic function

Area of Science:

• Endocrinology
• Gastroenterology
• Metabolic Disorders

Background:

• Chronic pancreatitis often leads to secondary diabetes, impacting pancreatic B cell function.
• Assessing the relationship between exocrine and endocrine pancreatic function is crucial for understanding disease progression.

Purpose of the Study:

• To evaluate exocrine pancreatic function in patients with chronic pancreatitis.
• To assess B cell function and its correlation with pancreatic enzyme secretion.
• To compare residual insulin secretion in insulin-treated diabetes secondary to chronic pancreatitis with Type 1 diabetes.

Main Methods:

• Utilized Lundh meal test and secretin-cholecystokinin test for exocrine function assessment.
• Measured C-peptide concentration after oral glucose and intravenous glucagon stimulation for B cell function.
• Analyzed correlations between C-peptide response, pancreatic enzymes (lipase, amylase), and diabetes duration.

Main Results:

• A strong correlation was observed between C-peptide response to glucagon and oral glucose (r = 0.88).
• Plasma C-peptide levels significantly correlated with post-prandial lipase (r = 0.72) and amylase (r = 0.64) concentrations and amylase output (r = 0.64).
• Insulin-treated patients with chronic pancreatitis retained residual B cell function, which decreased with longer diabetes duration.

Conclusions:

• B cell function is significantly correlated with pancreatic enzyme secretion in chronic pancreatitis.
• Patients with insulin-treated diabetes secondary to chronic pancreatitis exhibit residual insulin secretion similar to Type 1 diabetes patients.