EXOCRINE PANCREATIC INSUFFICIENCY IN CHILDREN WITH TYPE 1 DIABETES MELLITUS: A NEW PROBLEM OF PEDIATRIC GASTROENTEROLOGY

A A Nizhevich,A M Farkhutdinova,O A Malievskii,E N Akhmadeeva,G M Yakupova

doi:10.15690/vsp.v12i1.578

Abstract

One of the complications of diabetes mellitus is the development of pancreatic exocrine insufficiency. Fecal elastase 1 is a good marker of pancreatic exocrine secretion. The aim of the study was to evaluate the pancreatic exocrine secretion in children with type 1 diabetes mellitus with fecal elastase 1 test to estimate the possible need for exogenous pancreatic enzyme replacement therapy. The exocrine pancreatic function was evaluated in 54 diabetic children on the basis of steatocrite test and a determination of fecal elastase 1 concentrations. Compared to the controls, the diabetic children had significantly lower levels of fecal elastase 1 concentration (p<0,001). Steatorrhoea was registered in all patients with fecal elastase 1 level < 200 µg/g stool. All those patients were treated with pancreatin (creon) for 1 month. A reduction of fat excretion was observed in the pancreatin treated group at the end of the study. Pancreatin replacement therapy can be used safely in children with type 1 diabetes mellitus associated with exocrine pancreatic insufficiency.

Highlights

One of the complications of diabetes mellitus is the development of pancreatic exocrine insufficiency
Fecal elastase 1 is a good marker of pancreatic exocrine secretion
The aim of the study was to evaluate the pancreatic exocrine secretion in children with type 1 diabetes mellitus with fecal elastase 1 test to estimate the possible need for exogenous pancreatic enzyme replacement therapy

Summary

Introduction

One of the complications of diabetes mellitus is the development of pancreatic exocrine insufficiency. Цель исследования: оценить частоту экзокринной недостаточности поджелудочной железы у детей с сахарным диабетом 1-го типа и эффективность заместительной терапии препаратами панкреатических ферментов. При сравнении показателей было отмечено, что у пациентов группы контроля концентрация эластазы в кале была существенно выше, чем у пациентов с СД с наличием экзокринной недостаточности (min–max 264,5–803,5 мкг/г; медиана 406,1 мкг/г; p < 0,001).

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