TY - JOUR
T1 - Pancreatic exocrine insufficiency in diabetes mellitus - prevalence and characteristics
AU - Søfteland, Eirik
AU - Poulsen, Jakob Lykke
AU - Starup-Linde, Jakob
AU - Christensen, Trine Tang
AU - Olesen, Søren Schou
AU - Singh, Simran
AU - Vestergaard, Peter
AU - Drewes, Asbjørn Mohr
AU - Dimcevski, Georg
N1 - Copyright © 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
PY - 2019/10
Y1 - 2019/10
N2 - Background: The prevalence of pancreatic exocrine insufficiency (PEI) in diabetes mellitus (DM) varies widely between studies, which may be explained by methodological problems. We aimed to establish the prevalence of PEI in DM using the faecal elastase-1 (FE-1) assay as a screening test, and to further investigate these patients by the mixed
13C-triglyceride (
13C-MTG) breath test. Methods: One hundred and thirty-three consecutive type 1 or type 2 DM patients without known exocrine pancreatic disorders were recruited. Demographic parameters, stool consistency, stool frequency, routine laboratory tests, and the presence of DM complications were registered. An FE-1 value <200 μg/g was used as the screening cut-off for PEI, and patients with FE-1 values below this level were referred for a
13C-MTG breath test. Results: One hundred and two patients returned faecal samples. The prevalence of PEI as measured by low FE-1 was 13%. Insulin usage, type 1 DM, and DM duration were associated with low FE-1. Stool habits were unaffected by low FE-1. Twelve out of 13 patients with low FE-1 performed the breath test, which was normal in all cases. Conclusions: The prevalence of PEI defined by FE-1 was low in our mixed cohort of type 1 and 2 DM patients. Furthermore, there was a discrepancy between FE-1 and the breath test. Hence, the role of FE-1 in evaluating pancreatic exocrine function in DM should be evaluated in larger studies in order to clarify the association between low FE-1 and clinically relevant PEI.
AB - Background: The prevalence of pancreatic exocrine insufficiency (PEI) in diabetes mellitus (DM) varies widely between studies, which may be explained by methodological problems. We aimed to establish the prevalence of PEI in DM using the faecal elastase-1 (FE-1) assay as a screening test, and to further investigate these patients by the mixed
13C-triglyceride (
13C-MTG) breath test. Methods: One hundred and thirty-three consecutive type 1 or type 2 DM patients without known exocrine pancreatic disorders were recruited. Demographic parameters, stool consistency, stool frequency, routine laboratory tests, and the presence of DM complications were registered. An FE-1 value <200 μg/g was used as the screening cut-off for PEI, and patients with FE-1 values below this level were referred for a
13C-MTG breath test. Results: One hundred and two patients returned faecal samples. The prevalence of PEI as measured by low FE-1 was 13%. Insulin usage, type 1 DM, and DM duration were associated with low FE-1. Stool habits were unaffected by low FE-1. Twelve out of 13 patients with low FE-1 performed the breath test, which was normal in all cases. Conclusions: The prevalence of PEI defined by FE-1 was low in our mixed cohort of type 1 and 2 DM patients. Furthermore, there was a discrepancy between FE-1 and the breath test. Hence, the role of FE-1 in evaluating pancreatic exocrine function in DM should be evaluated in larger studies in order to clarify the association between low FE-1 and clinically relevant PEI.
KW - Diabetes mellitus
KW - Faecal elastase-1
KW - Mixed C-triglyceride breath test
KW - Pancreatic exocrine insufficiency
UR - http://www.scopus.com/inward/record.url?scp=85070213644&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2019.07.021
DO - 10.1016/j.ejim.2019.07.021
M3 - Journal article
C2 - 31402275
SN - 0953-6205
VL - 68
SP - 18
EP - 22
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
ER -