Opinion Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2019; 25(22): 2699-2705
Published online Jun 14, 2019. doi: 10.3748/wjg.v25.i22.2699
Which factors determine exocrine pancreatic dysfunction in diabetes mellitus?
Mustafa Altay
Mustafa Altay, Department of Endocrinology and Metabolism, University of Health Sciences, Keçiören Health Administration and Research Center, Ankara 06100, Turkey
Author contributions: Only Altay M contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Supported by: no dedicated source of funding.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mustafa Altay, MD, Professor, Department of Endocrinology and Metabolism, University of Health Sciences, Keçiören Health Administration and Research Center, Keçiören, Ankara 06290, Turkey. mustafa.altay@sbu.edu.tr
Telephone: +90-312-3569000 Fax: +90-312-3569002
Received: February 21, 2019
Peer-review started: February 22, 2019
First decision: March 27, 2019
Revised: April 4, 2019
Accepted: April 19, 2019
Article in press: April 20, 2019
Published online: June 14, 2019
Processing time: 113 Days and 15.6 Hours
Abstract

The exocrine structure is significantly affected by diabetes because of endocrine structure-function disorder within the pancreas. Exocrine pancreatic dysfunction (EPD) is the general name of the malabsorption process resulting from inadequate production, release, decreased activation, and/or insufficient degradation of enzymes required for digestion from pancreatic acinar cells. It is important to diagnose patients early and correctly, since there may be both macro- and micro-nutrient deficiency in EPD. In this paper, EPD, the diabetes-EPD relationship, and the predictive, effective factors affecting the emergence of EPD are briefly explained and summarized with contemporary literature and our experienced based on clinical, lab, and radiological findings.

Keywords: Exocrine pancreas; Diabetes mellitus; Fecal elastase; Malabsorption; Chronic complication

Core tip: The early diagnosis of exocrine pancreatic dysfunction cases and initiation of treatment in diabetic patients are important. From this point of view, it is also important to obtain clinical signs and to apply clinical practice to the diagnosis of mild to moderate cases. Direct or indirect exocrine pancreatic dysfunction testing for all diabetic patients is not cost-effective. In this context, we must determine which diabetic patients should be tested.