Diabetes mellitus is associated in some patients with exocrine pancreatic insufficiency. This applies in particular to type 1 diabetics. Examination of the external pancreatic secretion is assessed by pretentious and expensive tests using stimulation of the gland by enterohormones, because non-invasive tests are not sufficiently 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, where the authors proved in 70.0 % a reduction already in medium severe forms of chronic pancreatitis (classification 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 sugar level at the time. The authors draw attention to the fact that in subjects with type 1 diabetes where even during compensation loss of body weight persists, it is important to consider possible exocrine pancreatic insufficiency and supplement the patients with pancreatic enzymes.

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