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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitř. Lék., 48, 2002, No. 9, p. 898 - 905 |
Diabetes Mellitus Associated with Chronic Pancreatitis Perušičová J. Diabetologické centrum VFN, III. interní klinika 1. Lékařská fakulty UK, Praha, přednosta doc. MUDr. Š. Svačina, DrSc. |
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Summary: Diabetes mellitus (DM) as part of chronic pancreatitis (ChP) belongs into the group of secondary
DM with typical insulin deficiency. The prevalence and incidence of DM in ChP depends on the
selected diagnostic criteria, geographical conditions and duration and grade of pancreatitis. Based
on our findings during a 15-year investigation of impaired glucose tolerance and insulin
secretion in patients with ChP the authors submit some partial (published and unpublished)
results. The largest investigated group were 122 patients with ChP diagnosed according to the
morphological appearance during ERCP. The authors detected a mutual close relationship between
the extent of morphological damage of the efferent system of the pancreas on one hand and
impaired glucose metabolism and endogenous insulin secretion on the other hand. It was revealed
that values of C-peptide are in patients with ChP and normal glucose tolerance significantly
lower as compared with the healthy population, and in patients with ChP and DM they are
significantly lower as compared with non-obese type 2 diabetics. With the persistence of ChP the
C-peptide levels decline gradually and the incidence of diabetes increases but even when DM
persists in ChP C-peptide does not reach zero values as in type 1 DM. For detection of diabetes in
ChP assessment of the fasting blood sugar level does not suffice and an oral glucose tolerance test
must be made.
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