External Pancreatic Secretion in Diabetes Mellitus

Abstract

Whether changes in external pancreatic secretions can occur in diabetes mellitus has long been debated. Responses of the duodenal contents and of serum amylase and lipase following pancreozymin-secretin stimulation were studied in various groups of patients with diabetes mellitus. In 50 randomized diabetics, 20 had abnormal external secretory function of the pancreas. The most common abnormality was low amylase output. Eighteen of 20 had no clinical evidence of exocrine pancreatic disease. The rest of 20 had organic disease of the pancreas. Abnormal external pancreatic secretion occurred more frequently in juvenile diabetics and was found in 10 of 13 patients studied. The duration and severity of diabetes or the dose of insulin required were not related to the findings of the external pancreatic secretion. In a group of 21 patients admitted for their diabetes with unexplained gastrointestinal symptoms or signs by routine laboratory studies, 13 yielded abnormal external pancreatic secretory results and 7 abnormal serum enzymes. Increased incidence of organic pancreatic disease was found in this group. Five were found to have chronic relapsing pancreatitis, three acute pancreatitis, and six, cancer of the pancreas.