title: Pancreatic exocrine insufficiency in type 1 and type 2 diabetics of Indian origin.
abstract: BACKGROUND
  Pancreatic exocrine insufficiency has been frequently described in both type 1 and type 2 diabetes. Fecal elastase test has been demonstrated to have good correlation with direct tests for exocrine function, especially in moderate to severe cases. There are no data on the prevalence of pancreatic exocrine insufficiency in Indian patients with diabetes utilizing FEC concentrations. The objective of our study is to evaluate the prevalence of pancreatic exocrine insufficiency (PEI) in type 1 and type 2 diabetes and study the impact of PEI on glycemic control and metabolic parameters in diabetes.
  
  
  METHODS
  We conducted a cross sectional study on 89 T1D, 95 T2D patients and 90 healthy controls. Biochemical parameters including FBS, HbA1c, serum albumin and serum calcium were estimated. Fecal elastase concentrations (FEC) were estimated by ELISA. Patients with FEC <200 μg/g were considered to have pancreatic exocrine insufficiency.
  
  
  RESULTS
  The prevalence of PEI was 31.4% in T1D, 29.4% in T2D and 4.4% in controls (P < 0.01). A significant negative correlation was observed between FEC levels and, both FBS and HbA1c in diabetic patients. There was also a significant positive correlation between BMI and FEC. There was no significant association between low FEC and other biochemical parameters.
  
  
  CONCLUSIONS
  Nearly one third of patients with both T1D and T2D showed evidence of impaired exocrine function utilizing FEC test. Presence of PEI correlated with lower BMI and higher HbA1c.
authors.affiliation: Department of Endocrinology & Metabolism, Vydehi Institute of Medical Sciences, Bangalore, India. Electronic address: shvprsd.c@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Shivaprasad
authors.affiliation: Department of Endocrinology & Metabolism, Vydehi Institute of Medical Sciences, Bangalore, India.
authors.forename: Annie A
authors.initials: AA
authors.lastname: Pulikkal
authors.affiliation: BDH and CDEC, Bangalore, India.
authors.forename: K M Prasanna
authors.initials: KM
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D010188:Exocrine Pancreatic Insufficiency / Q000150:complications* / Q000235:genetics / Q000473:pathology; D005243:Feces / Q000201:enzymology; D006801:Humans; D007194:India; D008875:Middle Aged
keywords: Fecal elastase; India; Malabsorption; Pancreatic exocrine insufficiency; Type 1 diabetes; Type 2 diabetes