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Interactions between the endocrine and exocrine pancreas and their clinical relevance.
Pancreatology. 2009; 9(4):351-9.P

Abstract

In consequence of the close anatomical and functional links between the exocrine and endocrine pancreas, any disease affecting one of these parts will inevitably affect the other. Pancreatic conditions which might cause diabetes mellitus include acute and chronic pancreatitis, pancreatic surgery, cystic fibrosis and pancreatic cancer. The development of diabetes greatly influences the prognosis and quality of life of patients with exocrine pancreatic diseases. It may cause life-threatening complications, such as hypoglycemia, due to the lack of glucagon and the impaired absorption of nutrients, or the micro- and macrovascular complications may impair the organ functions. Diabetes mellitus is an independent risk factor of mortality in those with exocrine pancreatic diseases. The treatment of pancreatic diabetes, a distinct metabolic and clinical form of diabetes, requires special knowledge. Diet and pancreatic enzyme replacement therapy may be sufficient in the early stages. Oral antidiabetic drugs are not recommended. If the diet proves inadequate to reach the glycemic goals, insulin treatment with multiple injections is required. Impairments of the exocrine pancreatic function and morphology in diabetic patients are frequent and well known. Atrophy of the exocrine tissue may be caused by the lack of trophic insulin, whereas pancreatic fibrosis can result from activation of stellate cells by hyperglycemia, or from microangiopathy and neuropathy. The regulation of the exocrine pancreatic function is also damaged because of the impaired effect of islet hormones. In the event of a proven impairment of the pancreatic exocrine function in diabetes mellitus, pancreatic enzyme replacement therapy is indicated. This may improve the nutritional condition of the patient and decrease the metabolic instability.

Authors+Show Affiliations

First Department of Medicine, University of Szeged, Szeged, Hungary. czal@in1st.szote.u-szeged.huNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19454837

Citation

Czakó, László, et al. "Interactions Between the Endocrine and Exocrine Pancreas and Their Clinical Relevance." Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], vol. 9, no. 4, 2009, pp. 351-9.
Czakó L, Hegyi P, Rakonczay Z, et al. Interactions between the endocrine and exocrine pancreas and their clinical relevance. Pancreatology. 2009;9(4):351-9.
Czakó, L., Hegyi, P., Rakonczay, Z., Wittmann, T., & Otsuki, M. (2009). Interactions between the endocrine and exocrine pancreas and their clinical relevance. Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], 9(4), 351-9. https://doi.org/10.1159/000181169
Czakó L, et al. Interactions Between the Endocrine and Exocrine Pancreas and Their Clinical Relevance. Pancreatology. 2009;9(4):351-9. PubMed PMID: 19454837.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interactions between the endocrine and exocrine pancreas and their clinical relevance. AU - Czakó,László, AU - Hegyi,Péter, AU - Rakonczay,Zoltán,Jr AU - Wittmann,Tibor, AU - Otsuki,Makoto, Y1 - 2009/05/18/ PY - 2009/5/21/entrez PY - 2009/5/21/pubmed PY - 2009/10/1/medline SP - 351 EP - 9 JF - Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] JO - Pancreatology VL - 9 IS - 4 N2 - In consequence of the close anatomical and functional links between the exocrine and endocrine pancreas, any disease affecting one of these parts will inevitably affect the other. Pancreatic conditions which might cause diabetes mellitus include acute and chronic pancreatitis, pancreatic surgery, cystic fibrosis and pancreatic cancer. The development of diabetes greatly influences the prognosis and quality of life of patients with exocrine pancreatic diseases. It may cause life-threatening complications, such as hypoglycemia, due to the lack of glucagon and the impaired absorption of nutrients, or the micro- and macrovascular complications may impair the organ functions. Diabetes mellitus is an independent risk factor of mortality in those with exocrine pancreatic diseases. The treatment of pancreatic diabetes, a distinct metabolic and clinical form of diabetes, requires special knowledge. Diet and pancreatic enzyme replacement therapy may be sufficient in the early stages. Oral antidiabetic drugs are not recommended. If the diet proves inadequate to reach the glycemic goals, insulin treatment with multiple injections is required. Impairments of the exocrine pancreatic function and morphology in diabetic patients are frequent and well known. Atrophy of the exocrine tissue may be caused by the lack of trophic insulin, whereas pancreatic fibrosis can result from activation of stellate cells by hyperglycemia, or from microangiopathy and neuropathy. The regulation of the exocrine pancreatic function is also damaged because of the impaired effect of islet hormones. In the event of a proven impairment of the pancreatic exocrine function in diabetes mellitus, pancreatic enzyme replacement therapy is indicated. This may improve the nutritional condition of the patient and decrease the metabolic instability. SN - 1424-3911 UR - https://www.unboundmedicine.com/medline/citation/19454837/Interactions_between_the_endocrine_and_exocrine_pancreas_and_their_clinical_relevance_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1424-3903(09)80048-3 DB - PRIME DP - Unbound Medicine ER -