Evolution of acute pancreatitis in diabetes mellitus.
OBJECTIVE
The aim of the study was to identify whether the presence of diabetes may in some way condition the evolution of acute pancreatitis.


METHODS
The study included 16 patients who had been admitted to hospital following an acute episode of pancreatitis. Eight subjects were diabetic and eight formed the control group. The mean age of patients was 44.07+/-16.97. All patients were monitored for a period of 10 days, during which serum amylase and lipase levels were controlled. Patients with other pathologies were excluded from the study.


RESULTS
The results showed that the levels of these two enzymes peaked in diabetic patients, not within the first 24 hours as in the control group, but within approximately 48 hours. Moreover, after day 5-6, the serum levels of the two enzymes in diabetics fell below the values found in non-diabetic patients. Enzyme levels in alcoholic patients were lower compared to non-alcoholic patients, and this reduction was even greater in those with diabetes. Another finding observed in the four patients who died is the negative prognosis of persistent hyperamylasemia and hyperlipasemia beyond the sixth day.


CONCLUSIONS
From an analysis of the results we can hypothesise that either diabetics present a functional deficiency of the exocrine pancreas resulting in the extension of so-called pancreatic mutism, or the presence of microangiopathic complications causes vasal sclerosis that, in addition to diabetic neuropathy, leads to reduced and delayed levels of circulating enzymes.
Department of Internal Medicine and Specialist Internal Procedures, Catania University--Catania.
E
E
Napoli
A
A
Velardita
N
N
Monterosso