Exocrine pancreatic insufficiency at diabetes mellitus
Abstract
The aim of review. To give the characteristic of exocrine pancreatic insufficiency in diabetes mellitus (DM).
Original positions. Exocrine function of the pancreas is reduced in 40–80% of patients with insulindependent and in 15–73% of patients with 2nd type diabetes mellitus. Exocrine pancreatic insufficiency is more frequently of mild or moderate degree, severe insufficiency with development of steatorrhea occurs rarely. Mechanism of decrease of exocrine pancreatic secretion at DM is related to disbalance of hormones inhibiting and stimulating pancreatic secretion, fibrosis of the gland as a result of diabetic angiopathy as well as immune disorders, autonomous neuropathy, disorders of production of gastrointestinal regulatory mediators (motilin, pancreatic polypeptide, etc.), inhibiting effect of diabetic acidosis on exocrine secretion of pancreas. At DM of the 2nd type mechanisms, secondary to metabolic syndrome are involved in pathogenesis of exocrine pancreatic failure. Clinical manifestations related to digestive organs in diabetes mellitus are caused by diabetic gastro-, entero-, colopathy, as well as by exocrine pancreatic insufficiency. In the treatment adequate enzyme supplementation therapy and treatment of hyperglycemia play major role.
Conclusion. Exocrine pancreatic insufficiency plays major role in development of pain syndrome, dyspepsia, disorders of stool at patients of DM.
About the Authors
N. B. GubergritsRussian Federation
P. G. Fomenko
Russian Federation
V. Ya. Kolkina
Russian Federation
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For citations:
Gubergrits N.B., Fomenko P.G., Kolkina V.Ya. Exocrine pancreatic insufficiency at diabetes mellitus. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2009;19(5):61-67. (In Russ.)
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