Does Blood Glucose Regulation in Adults with Type 2 Diabetes Affect Exocrine Pancreatic Functions?

ABSTRACT

Objective: The purpose of this study was to assess the possible effects of blood glucose regulation on pancreatic exocrine functions in type 2 diabetes mellitus (T2DM) patients with poor glycemic control. Material and Methods: This prospective clinical study was performed with 20 patients with poorly controlled T2DM (HbA1c >10%) and age- and sex-matched 20 healthy controls. At the beginning of the study, metabolic parameters and fecal elastase-1 (FE-1) levels, one of the markers of pancreatic exocrine insufficiency (PEI), were compared between the patient and control groups. In addition, after blood glucose regulation was achieved with at least three months of intensive insulin therapy in the patient group, FE-1 levels and metabolic parameters were compared with pre-treatment. PEI was defined as FE-1 levels lower than 200 μg/g. Results: FE-1 levels were significantly lower in the T2DM group than the control group (median values for patients=333.1 μg/g and controls= 508.5 μg/g; p=0.013). PEI was detected in three patients (15%) but none in the control group. After intensive insulin therapy, T2DM patients FE-1 levels significantly increased compared to their pre-treatment (pre-treatment median: 333.15 (192.60) μg/g, post-treatment median: 415.40 (300.77) μg/g; p=0.044). The major factors impacting this increase were the duration of diabetes and the change in HbA1c levels. Conclusions: FE-1 levels in patients with poorly controlled T2DM were lower than the healthy control group, which significantly increased with blood glucose regulation.