Skip to main content
Erschienen in: Acta Diabetologica 6/2019

10.02.2019 | Original Article

Nutritional markers in patients with diabetes and pancreatic exocrine failure

verfasst von: Laure Alexandre-Heymann, Amal Y. Lemoine, Samir Nakib, Nathalie Kapel, Séverine Ledoux, Etienne Larger

Erschienen in: Acta Diabetologica | Ausgabe 6/2019

Einloggen, um Zugang zu erhalten

Abstract

Aims

Altered pancreatic exocrine function can be observed in patients with type 1 or type 2 diabetes. In the present study, we evaluated the potential nutritional consequences of this dysfunction.

Methods

Serum concentrations of nutritional markers, including albumin, cholesterol, triacylglycerol, vitamins A, D, and E, were assessed in a cohort of 468 patients (137 with type 1 diabetes and 331 with type 2 diabetes), after exclusion of the patients with a CRP > 10 mg/l. These patients were compared with 47 patients with diseases of the exocrine pancreas and diabetes (type 3c diabetes or pancreatogenic diabetes). Fecal elastase-1 and chymotrypsin concentrations were measured and patients with type 1 and type 2 diabetes were divided into three groups according to whether zero (group NN), one (group LN), or both (group LL) concentrations were decreased.

Results

Several markers differed significantly between the groups of patients, including BMI, albumin, phosphorus, and fat-soluble vitamins. Patients with pancreatogenic diabetes had markedly more profound alterations than patients with type 1 or type 2 diabetes and altered exocrine function. However, patients with type 1 or type 2 diabetes and decreased concentrations of both elastase-1 and chymotrypsin had lower albumin, phosphorus, and vitamin A than patients with normal pancreatic exocrine function.

Conclusions

Modest nutritional alterations were found in patients with type 1 or type 2 diabetes and altered exocrine function. Patients with type 1 or type 2 diabetes and altered exocrine function may thus deserve to be screened for nutritional deficiencies.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
4.
Zurück zum Zitat Chey WY, Shay H, Shuman CR (1963) External pancreatic secretion in diabetes mellitus. Ann Intern Med 59:812–821CrossRefPubMed Chey WY, Shay H, Shuman CR (1963) External pancreatic secretion in diabetes mellitus. Ann Intern Med 59:812–821CrossRefPubMed
6.
Zurück zum Zitat Mohan V, Snehalatha C, Ahmed MR et al (1989) Exocrine pancreatic function in tropical fibrocalculous pancreatic diabetes. Diabetes Care 12:145–147CrossRefPubMed Mohan V, Snehalatha C, Ahmed MR et al (1989) Exocrine pancreatic function in tropical fibrocalculous pancreatic diabetes. Diabetes Care 12:145–147CrossRefPubMed
7.
Zurück zum Zitat Goda K, Sasaki E, Nagata K et al (2001) Pancreatic volume in type 1 and type 2 diabetes mellitus. Acta Diabetol 38:145–149CrossRefPubMed Goda K, Sasaki E, Nagata K et al (2001) Pancreatic volume in type 1 and type 2 diabetes mellitus. Acta Diabetol 38:145–149CrossRefPubMed
20.
Zurück zum Zitat Ewald N, Raspe A, Kaufmann C et al (2009) Determinants of exocrine pancreatic function as measured by fecal elastase-1 concentrations (FEC) in patients with diabetes mellitus. Eur J Med Res 14:118–122PubMedPubMedCentral Ewald N, Raspe A, Kaufmann C et al (2009) Determinants of exocrine pancreatic function as measured by fecal elastase-1 concentrations (FEC) in patients with diabetes mellitus. Eur J Med Res 14:118–122PubMedPubMedCentral
22.
Zurück zum Zitat Ewald N, Bretzel RG, Fantus IG et al (2007) 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 Metab Res Rev 23:386–391. https://doi.org/10.1002/dmrr.708 CrossRefPubMed Ewald N, Bretzel RG, Fantus IG et al (2007) 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 Metab Res Rev 23:386–391. https://​doi.​org/​10.​1002/​dmrr.​708 CrossRefPubMed
32.
Zurück zum Zitat Krempf M, Ranganathan S, Ritz P et al (1991) Plasma vitamin A and E in type 1 (insulin-dependent) and type 2 (non-insulin-dependent) adult diabetic patients. Int J Vitam Nutr Res 61:38–42PubMed Krempf M, Ranganathan S, Ritz P et al (1991) Plasma vitamin A and E in type 1 (insulin-dependent) and type 2 (non-insulin-dependent) adult diabetic patients. Int J Vitam Nutr Res 61:38–42PubMed
36.
Zurück zum Zitat Wako Y, Suzuki K, Goto Y, Kimura S (1986) Vitamin A transport in plasma of diabetic patients. Tohoku J Exp Med 149:133–143CrossRefPubMed Wako Y, Suzuki K, Goto Y, Kimura S (1986) Vitamin A transport in plasma of diabetic patients. Tohoku J Exp Med 149:133–143CrossRefPubMed
37.
Zurück zum Zitat Löser C, Möllgaard A, Fölsch UR (1996) Faecal elastase 1: a novel, highly sensitive, and specific tubeless pancreatic function test. Gut 39:580–586CrossRefPubMedPubMedCentral Löser C, Möllgaard A, Fölsch UR (1996) Faecal elastase 1: a novel, highly sensitive, and specific tubeless pancreatic function test. Gut 39:580–586CrossRefPubMedPubMedCentral
Metadaten
Titel
Nutritional markers in patients with diabetes and pancreatic exocrine failure
verfasst von
Laure Alexandre-Heymann
Amal Y. Lemoine
Samir Nakib
Nathalie Kapel
Séverine Ledoux
Etienne Larger
Publikationsdatum
10.02.2019
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 6/2019
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-019-01294-w

Weitere Artikel der Ausgabe 6/2019

Acta Diabetologica 6/2019 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.