title: Exocrine pancreatic insufficiency in diabetes mellitus: a complication of diabetic neuropathy or a different type of diabetes?
abstract: Pancreatic exocrine insufficiency is a frequently observed phenomenon in type 1 and type 2 diabetes mellitus. Alterations of exocrine pancreatic morphology can also be found frequently in diabetic patients. Several hypotheses try to explain these findings, including lack of insulin as a trophic factor for exocrine tissue, changes in secretion and/or action of other islet hormones, and autoimmunity against common endocrine and exocrine antigens. Another explanation might be that diabetes mellitus could also be a consequence of underlying pancreatic diseases (e.g., chronic pancreatitis). Another pathophysiological concept proposes the functional and morphological alterations as a consequence of diabetic neuropathy. This paper discusses the currently available studies on this subject and tries to provide an overview of the current concepts of exocrine pancreatic insufficiency in diabetes mellitus.
authors.affiliation: Third Medical Department, University Hospital Giessen and Marburg, Giessen Site, Klinikstraße 33, 35392 Giessen, Germany. philip.d.hardt@innere.med.uni-giessen.de
authors.forename: Philip D
authors.initials: PD
authors.lastname: Hardt
authors.forename: Nils
authors.initials: N
authors.lastname: Ewald
mesh_terms: D000818:Animals; D015551:Autoimmunity; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D010188:Exocrine Pancreatic Insufficiency / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007328:Insulin / Q000378:metabolism; D046790:Pancreas, Exocrine / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D010187:Pancreatic Hormones / Q000378:metabolism; D012307:Risk Factors
chemical_list: D007328:Insulin; D010187:Pancreatic Hormones