Exocrine pancreatic ductograms in insulin-dependent diabetes mellitus.
OBJECTIVE
To examine the prevalence of abnormal pancreatic ductograms in patients with insulin-dependent diabetes mellitus (IDDM) and to determine the clinical characteristics of those patients.


METHODS
Pancreatic exocrine morphology was studied by endoscopic retrograde pancreatography (ERP) in 43 patients with IDDM, 12 patients with islet cell antibody (ICA)-positive non-insulin-dependent diabetes mellitus (NIDDM), and 22 patients with ICA-negative NIDDM.


RESULTS
ERP revealed a significantly higher prevalence of abnormal pancreatic ducts (dilation and stenosis, tortuosity, obstruction, and intraductal calculi) in the patients with IDDM (17/43, 40%) than in the patients with ICA-negative NIDDM (2/22, 9%, p = 0.018). IDDM patients who slowly progressed to insulin dependency more than 13 months after the onset of diabetes had a higher frequency of abnormal pancreatic ducts (13/22, 59%) than those who needed insulin therapy within 12 months after the onset (4/21, 19%, p = 0.016). There was no difference in duration of diabetes between the two groups. ICA-positive NIDDM patients also had a higher frequency of abnormal pancreatic ducts (7/12, 58%) than ICA-negative NIDDM patients (2/22, 9%, p = 0.0074).


CONCLUSIONS
These results indicate that a high proportion of IDDM patients who have prolonged histories of non-insulin dependency with ICA suffer pancreatic exocrine impairment. A similarity between IDDM with a slowly progressive clinical course and fibrocalculous pancreatic diabetes seen in tropical countries also was suggested.
Nakanishi
K
K
Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan.
Kobayashi
T
T
Miyashita
H
H
Okubo
M
M
Sugimoto
T
T
Murase
T
T
Hashimoto
M
M
Fukuchi
S
S
Kosaka
K
K
D001323:Autoantibodies / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging*; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging*; D011859:Radiography
D001323:Autoantibodies