OBJECTIVE: Exocrine function has been described in patients with diabetes. We hypothetized that patients with exocrine dysfunction have pancreatic atrophy. METHODS: This is a cohort study of hospitalized patients. Thirty-five patients were selected after detection of impaired exocrine function in routine tests, and 17 patients were matched for age and body mass index to the previous cohort. The pancreatic volume was evaluated on sections of computed tomographic scans of the pancreas. Other investigations included a glucagon stimulation test and determination of fecal elastase-1 concentration and chymotrypsin activity. RESULTS: Fifty-two patients participated in this study, 24 with type 1 diabetes and 28 with type 2 diabetes. Duration of diabetes was 15 years (5-26 years; median [interquartile range]). The pancreatic volume, 42 cm (25-57 cm), was decreased in most patients. It did not differ in patients with type 1 diabetes compared with those with type 2 diabetes. It was decreased in patients treated with insulin and in those with low elastase-1 concentration or low chymotrypsin activity. In the multiple linear regression analysis, the pancreatic volume correlated with chymotrypsin activity and stimulated C-peptide. CONCLUSIONS: We have unraveled a link between 2 old observations in patients with diabetes: atrophy of the pancreas and exocrine deficiency. These observations give credence to the reality of the exocrine dysfunction in patients with diabetes.
OBJECTIVE: Exocrine function has been described in patients with diabetes. We hypothetized that patients with exocrine dysfunction have pancreatic atrophy. METHODS: This is a cohort study of hospitalized patients. Thirty-five patients were selected after detection of impaired exocrine function in routine tests, and 17 patients were matched for age and body mass index to the previous cohort. The pancreatic volume was evaluated on sections of computed tomographic scans of the pancreas. Other investigations included a glucagon stimulation test and determination of fecal elastase-1 concentration and chymotrypsin activity. RESULTS: Fifty-two patients participated in this study, 24 with type 1 diabetes and 28 with type 2 diabetes. Duration of diabetes was 15 years (5-26 years; median [interquartile range]). The pancreatic volume, 42 cm (25-57 cm), was decreased in most patients. It did not differ in patients with type 1 diabetes compared with those with type 2 diabetes. It was decreased in patients treated with insulin and in those with low elastase-1 concentration or low chymotrypsin activity. In the multiple linear regression analysis, the pancreatic volume correlated with chymotrypsin activity and stimulated C-peptide. CONCLUSIONS: We have unraveled a link between 2 old observations in patients with diabetes: atrophy of the pancreas and exocrine deficiency. These observations give credence to the reality of the exocrine dysfunction in patients with diabetes.
Authors: Martha L Campbell-Thompson; Stephanie L Filipp; Joseph R Grajo; Bimota Nambam; Richard Beegle; Erik H Middlebrooks; Matthew J Gurka; Mark A Atkinson; Desmond A Schatz; Michael J Haller Journal: Diabetes Care Date: 2018-12-14 Impact factor: 19.112
Authors: Brendan M McCleary; Andrew T Trout; Lin Fei; Qin Sun; Suraj D Serai; Jonathan R Dillman; Maisam Abu-El-Haija Journal: Pediatr Radiol Date: 2020-02-11
Authors: Melena D Bellin; Mark Lowe; M Bridget Zimmerman; Michael Wilschanski; Steven Werlin; David M Troendle; Uzma Shah; Sarah J Schwarzenberg; John F Pohl; Emily Perito; Chee Yee Ooi; Jaimie D Nathan; Veronique D Morinville; Brian A McFerron; Maria R Mascarenhas; Asim Maqbool; Quin Liu; Tom K Lin; Sohail Z Husain; Ryan Himes; Melvin B Heyman; Tanja Gonska; Matthew J Giefer; Cheryl E Gariepy; Steven D Freedman; Douglas S Fishman; Bradley Barth; Maisam Abu-El-Haija; Aliye Uc Journal: J Pediatr Gastroenterol Nutr Date: 2019-11 Impact factor: 2.839
Authors: I I Oz; M Bilici; I Serifoglu; D Karakaya Arpaci; M C Buyukuysal; T Bayraktaroglu Journal: Acta Endocrinol (Buchar) Date: 2017 Apr-Jun Impact factor: 0.877