title: Endocrine pancreatic insufficiency in chronic pancreatitis.
abstract: Chronic pancreatitis (CP) is considered to be a rare cause of diabetes mellitus. However, in both the developed and developing world, there is an increasing number of patients suffering from pancreatitis probably due to lifestyle changes, which is partially associated with both social factors and the poor health status of immigrants. Owing to these circumstances, CP has evolved with one of the possible causes of diabetes in a selected group of patients and should be included in the differential diagnosis of diabetes. Several studies have shown that the long-term rate of diabetic complications in patients with CP and insulin-dependent diabetes is similar to that in patients with type 1 diabetes of equal duration. The hypothesis that early diagnosis of CP should result in better prognosis is not validated and may complicate the issue, since the risk of diabetes has been shown to increase significantly only once pancreatic calcification has developed. Accumulative evidence suggests that the risk of diabetes is not influenced by elective pancreatic surgical procedures other than distal pancreatectomy. The lack of contemporary data points to the urgent need for large prospective studies in order to accurately evaluate the special characteristics of disorders in glucose homeostasis in patients with CP.
authors.affiliation: Endocrine Department, Hippokrateion Hospital of Athens, Athens, Greece. drangelnick@hotmail.com
authors.forename: Nicholas
authors.initials: N
authors.lastname: Angelopoulos
authors.forename: Christos
authors.initials: C
authors.lastname: Dervenis
authors.forename: Anastasia
authors.initials: A
authors.lastname: Goula
authors.forename: Grigorios
authors.initials: G
authors.lastname: Rombopoulos
authors.forename: Sarantis
authors.initials: S
authors.lastname: Livadas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kaltsas
authors.forename: Victoria
authors.initials: V
authors.lastname: Kaltzidou
authors.forename: George
authors.initials: G
authors.lastname: Tolis
mesh_terms: D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000209:etiology*; D010188:Exocrine Pancreatic Insufficiency / Q000209:etiology*; D006801:Humans; D010195:Pancreatitis / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery