Pancreatin therapy in patients with insulin-treated diabetes mellitus and exocrine pancreatic insufficiency according to low fecal elastase 1 concentrations. Results of a prospective multi-centre trial

Diabetes/Metabolism Research and Reviews

Volumn 23, Issue 5, 2007, Pages 386-391

  Ewald, Nils ^a   Bretzel, Reinhard G ^a   Fantus, Ivan G ^c   Hollenhorst, Manfred ^b   Kloer, Hans U ^a   Hardt, Philip D ^a  

^a UNIVERSITY HOSPITAL GIESSEN   (Germany)

^b JUSTUS LIEBIG UNIVERSITY   (Germany)

^c MOUNT SINAI HOSPITAL   (Canada)

Author keywords

Enzyme replacement therapy; Exocrine pancreatic function; Fecal elastase 1 concentration; IDDM; Pancreatitis; Type 1 diabetes mellitus

Indexed keywords

GLUCOSE; HEMOGLOBIN A1C; INSULIN; KREON; PANCREATIC ELASTASE; PANCREATIN; PLACEBO;

ADULT; ARTICLE; CLINICAL ASSESSMENT; CLINICAL FEATURE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DIABETES MELLITUS; DIARRHEA; DIET RESTRICTION; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; DRUG INDUCED HEADACHE; DRUG SAFETY; DYSPEPSIA; ENZYME REPLACEMENT; FECES ANALYSIS; FEMALE; GLUCOSE METABOLISM; HUMAN; HYPERGLYCEMIA; HYPOGLYCEMIA; INFECTION; MAJOR CLINICAL STUDY; MALE; MULTICENTER STUDY; OBSERVATIONAL STUDY; PAIN; PANCREAS EXOCRINE INSUFFICIENCY; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL;

DIABETES MELLITUS, TYPE 1; FECES; GASTROINTESTINAL AGENTS; HEMOGLOBIN A, GLYCOSYLATED; HUMANS; HYPOGLYCEMIC AGENTS; INSULIN; PANCREATIC DISEASES; PANCREATIC ELASTASE; PANCREATIN; PATIENT SELECTION; PLACEBOS; PREVALENCE; PROSPECTIVE STUDIES;

EID: 34447620321     PISSN: 15207552     EISSN: 15207560     Source Type: Journal    
DOI: 10.1002/dmrr.708     Document Type: Article

References (27)

1. Williams JA, Goldfine ID. The insulin-pancreatic acinar axis. Diabetes 1985; 34: 980-986.
2. Henderson JR. Why are the islets of Langerhans? Lancet 1969; 2: 469-470.
3. Chey WY, Shay H, Shuman CR. External pancreatic secretion in diabetes mellitus. Ann Intern Med 1963; 59: 812-821.
4. Vacca JB, Henke WJ, Knight WA. The exocrine pancreas in diabetes mellitus. Ann Intern Med 1964; 61: 242-247.
5. Frier BM, Saunders JHB, Wormsley KG, Bouchier IAD. Exocrine pancreatic function in juvenile-onset diabetes mellitus. Gut 1976; 17: 685-691.
6. Lankisch PG, Manthey G, Otto J, Talaulicar M, Willms B, Creutzfeldt W. Exocrine pancreatic function in insulin-dependent diabetes mellitus. Digestion 1982; 25: 210-216.
7. Gilbeau J, Poncelet V, Libon E, Derue G, Heller FR. The density, contour and thickness of the pancreas in diabetics. Am J Roentgenol 1992; 159: 527-531.
8. Lazarus SS, Volk BW. Pancreas in maturity-onset diabetes. Arch Pathol (Chic) 1961; 71: 44-48.
9. Gepts W. Pathology of the pancreas in juvenile diabetes. Diabetes 1965; 14: 619-633.
10. Loehr M, Kloeppel G. Residual insulin positivity and pancreatic atrophy in relation to duration of chronic type 1 (insulin dependent) diabetes mellitus and microangiopathy. Diabetologia 1987; 30: 757-762.
11. Kobayashi T, Nakanishi K, Sugimoto T, Murase T, Kosaka K. Histopathological changes of the pancreas in islet cell antibodies (ICA)-positive subjects before and after the clinical onset of insulin-dependent diabetes mellitus. Diabetes 1988; 37: 24A.
12. Nakanishi K, Kobayashi T, Miyashita H, et al. Exocrine pancreatic ductograms in insulin-dependent diabetes mellitus. Am J Gastroenterol 1994; 89: 762-766.
13. Hardt PD, Killinger A, Nalop J, Schnell-Kretschmer H, Zekorn T, Kloer HU. Chronic pancreatitis and diabetes mellitus. A retrospective analysis of 156 ERCP investigations in patients with insulin-dependent and non-insulin-dependent diabetes mellitus. Pancreatology 2002; 2: 30-33.
14. Nakamura Z, Imamura K, Takebe K, et al. Correlation between pancreatic endocrine and exocrine function and characteristics of pancreatic endocrine function in patients with diabetes mellitus owing to chronic pancreatitis. Int J Pancreatol 1996; 20: 169-175.
15. Hardt PD, Krauss A, Bretz L, et al. Pancreatic exocrine function in patients with type-1 and type-2 diabetes mellitus. Acta Diabetol 2000; 37: 105-110.
16. Hardt PD, Hauenschild A, Nalop J, et al. High prevalence of exocrine pancreatic insufficiency in diabetes mellitus. A multicenter study screening fecal elastase 1 concentrations in 1,021 diabetic patients. Pancreatology 2003; 3(5): 395-402.
17. Rathmann W, Haastert B, Icks A, et al. Low fecal elastase 1 concentrations in Type 2 diabetes. Scand J Gastroenterol 2001; 36: 1056-1061.
18. Icks A, Haastert B, Giani G, Rathmann W. Low fecal elastase 1 in type 1 diabetes mellitus. Z Gastroenterol 2001; 39: 823-830.
19. Hardt PD, Hauenschild A, Jaeger C, et al. High prevalence of steatorrhea in 101 diabetic patients likely to suffer from exocrine pancreatic insufficiency according to low fecal elastase 1 concentrations: a prospective multicenter study. Dig Dis Sci 2003; 48(9): 1688-1692.
20. Teichmann J, Lange U, Hardt P, et al. Decreased pancreatic elastase i content: an independent risk factor of the osteoporosis in elderly women. Bone 2001; 28(Suppl.): S194.
21. Boden G. Obesity, free fatty acids, and insulin resistance. Curr Opin Endocrinol Diabetes 2001; 8: 235-239.
22. Glasbrenner B, Malfertheiner P, Kerner W, Scherbaum WA, Ditschuneit H. Effect of pancreatin on diabetes mellitus in chronic pancreatitis. Z Gastroenterol 1990; 28: 275-279.
23. O'Keefe SJ, Cariem AK, Levy M. The exacerbation of pancreatic endocrine dysfunction by potent pancreatic exocrine supplements in patients with chronic pancreatitis. J Clin Gastroenterol 2001; 32: 319-323.
24. Mohan V, Poongothai S, Pitchumoni CS. Oral pancreatic enzyme therapy in the control of diabetes mellitus in tropical calculous pancreatitis. Int J Pancreatol 1998; 24: 19-22.
25. Wuesten O, Balz CH, Bretzel RG, Kloer HU, Hardt PD. Impact of oral fat load on insulin output and glucose tolerance in healthy controls and obese patients without diabetes mellitus. Diabetes Care 2005; 28: 360-365.
26. Ebert R, Creutzfeldt W. Reversal of impaired GIP and insulin secretion in patients with pancreatogenic steatorrhea following enzyme substitution. Diabetologia 1980; 19(3): 198-204.
27. Nauck MA. Is glucagon-like peptide 1 an incretin hormone? Diabetologia 1999; 42(9): 1148-1149.