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

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 HbAlc >= 7% formed Group A (n = 59), and with HbAlc <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 mu g/g, vs. 454.6 +/- 147.3 mu g/g, p = 0.038). The PE-1 level was not correlated with HbAl c (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. Copyright (C) 2014, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.