Tags

Type your tag names separated by a space and hit enter

Screening for pancreatic exocrine insufficiency in patients with diabetes mellitus.
Am J Gastroenterol. 2003 Dec; 98(12):2672-5.AJ

Abstract

OBJECTIVES

Fecal elastase 1 (E1) is a relatively sensitive and specific indirect test of pancreatic exocrine function. Despite the high functional reserve of the pancreas, it is recognized that a significant proportion of diabetic patients may also have a deficit of the exocrine function. The aim of this study was to screen patients with diabetes mellitus (DM) for pancreatic exocrine insufficiency.

METHODS

A total of 80 patients were enrolled in this prospective study, including 42 patients with DM and 38 nondiabetic controls. Exclusion criteria were as follows: age >75 yr; alcohol intake >40 g/day; intake of orlistat or acarbose; and history of diarrhea, pancreatitis, GI surgery, immunodeficiency, or cancer. All patients underwent the same study protocol, which included clinical evaluation, determination of fecal E1, plain x-rays of the abdomen, and abdominal ultrasound. An immunoenzymatic method (ScheBoTech, Wettenburg, Germany) was used for E1 determination. Diagnosis of pancreatic insufficiency was established for a fecal E1 <200 microg/g.

RESULTS

The DM and control groups were comparable regarding age (62 +/- 10 yr vs 56 +/- 10 yr), sex (18 men and 24 women vs 15 men and 23 women), and proportion of patients with excess weight (50% vs 42%). Patients had DM diagnosed for 11.5 +/- 8 yr, with structural changes of the pancreas detected on ultrasound in three cases and calcifications in one case. There was no relationship between E1 determination <200 microg/g and the duration or the type of therapy for DM. Fifteen patients (36%) in the DM group had a fecal E1 <200 microg/g, compared with two patients (5%) in the control group (p < 0.05). In the DM group (n = 42), 11 patients with excess weight presented a fecal E1 <200 microg/g, whereas four patients with a BMI <25 presented this result (p < 0.05).

CONCLUSIONS

Pancreatic exocrine insufficiency occurs more frequently in diabetic patients than in controls. Diabetic individuals with excess weight (BMI >25) may be at increased risk for underlying exocrine pancreatic insufficiency.

Authors+Show Affiliations

Department of Gastroenterology, University Hospitals of Coimbra, Avenida Urbano Duarte, Quinta da Estrela, Lote 7, 6o B, Coimbra, Portugal.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14687815

Citation

Nunes, Amadeu C R., et al. "Screening for Pancreatic Exocrine Insufficiency in Patients With Diabetes Mellitus." The American Journal of Gastroenterology, vol. 98, no. 12, 2003, pp. 2672-5.
Nunes AC, Pontes JM, Rosa A, et al. Screening for pancreatic exocrine insufficiency in patients with diabetes mellitus. Am J Gastroenterol. 2003;98(12):2672-5.
Nunes, A. C., Pontes, J. M., Rosa, A., Gomes, L., Carvalheiro, M., & Freitas, D. (2003). Screening for pancreatic exocrine insufficiency in patients with diabetes mellitus. The American Journal of Gastroenterology, 98(12), 2672-5.
Nunes AC, et al. Screening for Pancreatic Exocrine Insufficiency in Patients With Diabetes Mellitus. Am J Gastroenterol. 2003;98(12):2672-5. PubMed PMID: 14687815.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Screening for pancreatic exocrine insufficiency in patients with diabetes mellitus. AU - Nunes,Amadeu C R, AU - Pontes,José M, AU - Rosa,Albano, AU - Gomes,Leonor, AU - Carvalheiro,Manuela, AU - Freitas,Diniz, PY - 2003/12/23/pubmed PY - 2004/2/10/medline PY - 2003/12/23/entrez SP - 2672 EP - 5 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 98 IS - 12 N2 - OBJECTIVES: Fecal elastase 1 (E1) is a relatively sensitive and specific indirect test of pancreatic exocrine function. Despite the high functional reserve of the pancreas, it is recognized that a significant proportion of diabetic patients may also have a deficit of the exocrine function. The aim of this study was to screen patients with diabetes mellitus (DM) for pancreatic exocrine insufficiency. METHODS: A total of 80 patients were enrolled in this prospective study, including 42 patients with DM and 38 nondiabetic controls. Exclusion criteria were as follows: age >75 yr; alcohol intake >40 g/day; intake of orlistat or acarbose; and history of diarrhea, pancreatitis, GI surgery, immunodeficiency, or cancer. All patients underwent the same study protocol, which included clinical evaluation, determination of fecal E1, plain x-rays of the abdomen, and abdominal ultrasound. An immunoenzymatic method (ScheBoTech, Wettenburg, Germany) was used for E1 determination. Diagnosis of pancreatic insufficiency was established for a fecal E1 <200 microg/g. RESULTS: The DM and control groups were comparable regarding age (62 +/- 10 yr vs 56 +/- 10 yr), sex (18 men and 24 women vs 15 men and 23 women), and proportion of patients with excess weight (50% vs 42%). Patients had DM diagnosed for 11.5 +/- 8 yr, with structural changes of the pancreas detected on ultrasound in three cases and calcifications in one case. There was no relationship between E1 determination <200 microg/g and the duration or the type of therapy for DM. Fifteen patients (36%) in the DM group had a fecal E1 <200 microg/g, compared with two patients (5%) in the control group (p < 0.05). In the DM group (n = 42), 11 patients with excess weight presented a fecal E1 <200 microg/g, whereas four patients with a BMI <25 presented this result (p < 0.05). CONCLUSIONS: Pancreatic exocrine insufficiency occurs more frequently in diabetic patients than in controls. Diabetic individuals with excess weight (BMI >25) may be at increased risk for underlying exocrine pancreatic insufficiency. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/14687815/Screening_for_pancreatic_exocrine_insufficiency_in_patients_with_diabetes_mellitus_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0002-9270&amp;date=2003&amp;volume=98&amp;issue=12&amp;spage=2672 DB - PRIME DP - Unbound Medicine ER -