Abstract
The consequences of the exocrine pancreatic insufficiency are well-known in pancreatic diabetes (DM). Aim: The aim of this study was to determine the frequency of low stool elastase activity in type-1 and type-2 DM patients (pts). The metabolic parameters and the chronic complications were evaluated in pts with normal and abnormal exocrine function and the effects of enzyme substitution were analysed. Patients and Methods: Stool elastase of 146 pts with non-pancreatic DM was measured by ELISA. Autonomic neuropathy (AN), peripheral sensory function, retinopathy, HbA1c, BMI, microalbuminuria (MAU), quality of life (QoL) were measured. Results: 41 pts (28%) had an affected exocrine function (elastase: 417±37 vs. 141±11 ug/g; mean of pts with normal vs. abnormal values, p 0.05). The severity of AN decreased (AN score: from 3.09±0.61 to 2.36±0.66, p>0.05). Conclusions: A moderately impaired exocrine pancreatic function is a characteristic finding in a high number of patients with both types of diabetes. This altered function is more severe in older patients. The enzyme substitution might have an important role in the treatment of diabetic patients with higher age, severe neuropathy and unstable glycemic control.
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