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 HbA1c ≥7% formed Group A ( n=59), and with HbA1c <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±171.1μg/g, vs. 454.6±147.3μg/g, p=0.038). The PE-1 level was not correlated with HbA1c ( 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 andB. 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. © 2014 IAP and EPC.