Prevalence of exocrine pancreatic insufficiency in type 2 diabetes mellitus with poor glycemic control

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] Vol. 14; no. 5; pp. 356 - 360
• Main Authors: Terzin, Viktória, Várkonyi, Tamás, Szabolcs, Annamária, Lengyel, Csaba, Takács, Tamás, Zsóri, Gábor, Stájer, Anette, Palkó, András, Wittmann, Tibor, Pálinkás, Attila, Czakó, László
• Format: Journal Article
• Language: English
• Published: Switzerland Elsevier B.V 01.09.2014; Elsevier Limited
• Subjects: Adult; Age; Aged; Aged, 80 and over; Biomarkers - metabolism; Blood Glucose - metabolism; Body mass index; Carrier Proteins - metabolism; Chronic pancreatitis; Colleges & universities; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Endocrinology & Metabolism; Enzymes; Exocrine pancreatic insufficiency; Exocrine Pancreatic Insufficiency - diagnosis; Exocrine Pancreatic Insufficiency - epidemiology; Exocrine Pancreatic Insufficiency - etiology; Exocrine Pancreatic Insufficiency - metabolism; Fecal elastase 1; Female; Follow-Up Studies; Gastroenterology and Hepatology; Glucose; Glycated Hemoglobin A - metabolism; Glycemic control; Humans; Hypoglycemia; Insulin; Male; Metabolism; Middle Aged; Morphology; Pancreas; Pancreas - pathology; Pancreatic Elastase; Pancreatic enzyme replacement; Prevalence; Prospective Studies; ultrasonography; DM; odds ratio; pancreatic elastase; NAFPD; PERT; HbA1c; US; nonalcoholic fatty pancreas disease; BMI; Glycemic control; OR; Exocrine pancreatic insufficiency; Diabetes mellitus; Fecal elastase 1; Chronic pancreatitis; body mass index; CP; CT; glycated hemoglobin; Pancreatic enzyme replacement; American Diabetes Association; pancreatic enzyme replacement therapy; PE-1; ADA; computer tomography
• ISSN: 1424-3903; 1424-3911
• DOI: 10.1016/j.pan.2014.07.004

Abstract Objectives To evaluate the relationship between exocrine pancreatic insufficiency and the level of glycemic control in diabetes (DM). Methods Patients with type 2 DM treated in our clinic were prospectively recruited into the study. Pancreatic diabetes was excluded. Cases with HbA1c ≥7% formed Group A ( n  = 59), and with HbA1c <7% Group B ( n  = 42). The fecal level of pancreatic elastase (PE-1) was measured and morphological examinations of the pancreas were performed. Results The PE-1 level was significantly lower in Group A than in Group B (385.9 ± 171.1 μg/g, vs. 454.6 ± 147.3 μg/g, p  = 0.038). The PE-1 level was not correlated with HbA1c ( r  = −0.132, p  = 0.187), the duration of DM ( r  = −0.046, p  = 0.65), age ( r  = 0.010, p  = 0.921), BMI ( r  = 0.203, p  = 0.059), or pancreatic steatosis ( r  = 0.117, p  = 0.244). The size of the pancreas did not differ significantly between Groups A and B. Conclusions An exocrine pancreatic insufficiency demonstrated by fecal PE-1 determination is more frequent in type 2 DM patients with poor glycemic control. The impaired exocrine pancreatic function cannot be explained by an alteration in the size of the pancreas or by pancreatic steatosis.