Exocrine pancreas functions in children with type 1 diabetes mellitus

Arab J Gastroenterol. 2021 Sep;22(3):236-239. doi: 10.1016/j.ajg.2021.05.018. Epub 2021 Sep 8.

Abstract

Background and study aim: We evaluated exocrine pancreas functions using a noninvasive indicator in a case-control study conducted on children and adolescents diagnosed with type 1 diabetes mellitus.

Patients and methods: Sixty-seven patients who participated in a summer camp were enrolled in this study. Nineteen healthy children in the same age group were assigned to the control group. Fecal pancreatic elastase was assayed using the enzyme-linked immunosorbent assay technique. Values higher than 200 µg/g were considered an indication of sufficient exocrine pancreatic functioning, values between 100 µg/g and 200 µg/g were considered mild exocrine pancreatic insufficiency, and values below 100 µg/g were considered severe exocrine pancreatic insufficiency.

Results: The mean concentration of fecal elastase was 158.38 ± 59.67 µg/g. The patients were assigned to three groups according to these values. Thirteen patients (22%) had sufficient fecal elastase levels, whereas 36 patients (62%) had mildly insufficient levels, and nine patients (16%) had severely insufficient fecal elastase concentrations. The levels of fecal elastase, amylase, lipase, and zinc were significantly different between the patients and controls (p < 0.001). Only the duration of diabetes was significantly different between patients with different severities of exocrine pancreatic insufficiency (p = 0.037). Additionally, the group with severe pancreatic insufficiency had more frequent hypoglycemic attacks.

Conclusion: Exocrine pancreatic insufficiency may develop in children with diabetes, and hypoglycemia attacks are observed more frequently depending on the severity of pancreatic insufficiency.

Keywords: Children; Fecal elastase; Type 1 diabetes mellitus.

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Diabetes Mellitus, Type 1*
  • Humans
  • Hypoglycemic Agents
  • Pancreas, Exocrine*
  • Pancreatic Diseases*

Substances

  • Hypoglycemic Agents