High prevalence of steatorrhea in 101 diabetic patients likely to suffer from exocrine pancreatic insufficiency according to low fecal elastase 1 concentrations: A prospective multicenter study

• Published in: Digestive diseases and sciences Vol. 48; no. 9; pp. 1688 - 1692
• Main Authors: HARDT, Philip D, HAUENSCHILD, Annette, JAEGER, Clemens, TEICHMANN, Joachim, BRETZEL, Reinhard G, KLOER, Hans U
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.09.2003; Springer Nature B.V
• Subjects: Associated diseases and complications; Biological and medical sciences; Celiac Disease - complications; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - enzymology; Diabetes Mellitus, Type 1 - physiopathology; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - enzymology; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Feces - enzymology; Female; Humans; Male; Medical sciences; Middle Aged; Pancreatic Elastase - analysis; Prospective Studies; Endocrinopathy; Human; Pancreatic elastase; Prevalence; Serine endopeptidases; Enzyme; Diabetes mellitus; Exocrine pancreas insufficiency; Statistical study; fat digestion; exocrine pancreatic function; Peptidases; Intestinal malabsorption; Digestive diseases; Hydrolases; Intestinal disease; Complication; pancreatitis; Diagnosis; Steatorrhea; elastase 1; diabetes; Pancreatic disease
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1023/a:1025422423435

Impaired exocrine pancreatic secretion has been frequently observed in diabetic patients by different methods, including direct function tests. However, the clinical importance remained unclear. In the present study, the fecal fat excretion in patients with type 1 or type 2 diabetes mellitus and exocrine dysfunction according to fecal elastase 1 concentrations <100 microg/g was investigated. Subjects with a history of gastrointestinal cancer, gastrointestinal surgery, alcohol abuse, or inflammatory diseases were excluded. In 101 patients the mean (+/- SD) fat excretion was 9.19 +/- 5.39 g. Only 41 patients (40.6%) had normal fat excretion <7 g/day. In 40 patients (39.6%), it was higher than 10 g/day, indicating relevant steatorrhea. The fat excretion did not correlate with diabetes type, duration, or clinical symptoms. This finding is of some clinical importance and might influence pathophysiological concepts and the management of diabetic patients.