Changes of Elastase 1 in Faeces of Diabetic Subjects

Overview

Diabetes mellitus is associated in some patients with exocrine pancreatic insufficiency. This applies in parti-cular to type 1 diabetics. Examination of the external pancreatic secretion is assessed by pretentious andexpensive tests using stimulation of the gland by enterohormones, because non-invasive tests are not suffici-ently sensitive for evaluation of the external pancreatic secretion if a mild morphological form of pancreatopathy is involved. Based on their own experience with examination of changes of elastase 1 in faeces, wherethe authors proved in 70.0 % a reduction already in medium severe forms of chronic pancreatitis (classificati-on according to ERCP), a group of subjects suffering from type 1 diabetes and type 2 diabetes was examined.The exocrine pancreatic secretion was reduced in 60.0 % of subjects with type 1 diabetes and only in 5.0 %with type 2 diabetes. This result correlated with the C-peptide level and was not affected by the blood sugarlevel at the time. The authors draw attention to the fact that in subjects with type 1 diabetes where evenduring compensation loss of body weight persists, it is important to consider possible exocrine pancreaticinsufficiency and supplement the patients with pancreatic enzymes.

Key words:
diabetes mellitus – elastase 1 – exocrine pancreatic function