Pancreatogenic diabetes vice versa: exocrine pancreatic insufficiency against the background of diabetes mellitus
Journal Title: Сучасна гастроентерологія - Year 2019, Vol 0, Issue 2
Abstract
The analysis has been performed for the normal physiological interrelations of exocrine and endocrine pancreatic parenchyma. There were elucidated literature data regarding pathogenesis, clinical peculiarities, treatment of pancreatogenic diabetes mellitus and exocrine pancreatic insufficiency secondary to the diabetes mellitus. It has been established that fecal elastase‑1 is an ideal biomarker for the diagnosis of exocrine pancreatic insufficiency in patients with type‑2 diabetes mellitus. The study results have been demonstrated, testifying a strong association of diabetes with the low fecal elastase‑1 levels, as well as direct correlation between levels of fecal elastase‑1 and C-peptide, lipase, C-reactive protein levels, body mass index, total 25(OH) vitamin D. The authors presented data regarding the existence of two intra-pancreatic axes of interconnections: one is involved in the regulation of insulin-mediated enzyme production via insulin-acinar axis; and another provides insulin release on account of the pancreatic enzymes via acini-insular axis. The concept of acini-islet-acinar axis has been presented. Thus, the exocrine pancreatic insufficiency can be considered as s complication of diabetes mellitus. The pathogenetic ground has been provided for the expediency of Creon indication in type 3 diabetes mellitus and for the treatment of exocrine pancreatic insufficiency in patients with diabetes mellitus. The Pancreatin therapy has been proved as a safe treatment for the patients with diabetes mellitus and exocrine pancreatic dysfunction.
Authors and Affiliations
N. B. Gubergrits, N. V. Belyayeva, O. Ye. Klochkov, P. G. Fomenko
Keywords
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- EP ID EP575171
- DOI 10.30978/MG-2019-2-81
- Views 129
- Downloads 0
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