Impaired exocrine pancreatic function in diabetics with diarrhea and peripheral neuropathy
- 1 June 1988
- journal article
- research article
- Published by Springer Nature in Digestive Diseases and Sciences
- Vol. 33 (6), 705-710
- https://doi.org/10.1007/bf01540434
Abstract
Exocrine pancreatic insufficiency has been observed in some diabetics with peripheral neuropathy and diarrhea. Several mechanisms may be responsible for this insufficiency: (1) pancreatic atrophy, (2) disruption of the cholinergic enteropancreatic reflexes, or (3) elevated serum levels of peptides such as glucagon and pancreatic polypeptide which are known to inhibit pancreatic exocrine secretion. To clarify the mechanism(s) involved in this exocrine pancreatic impairment, we studied 10 diabetics with diarrhea and peripheral neuropathy. Their results were compared to those of eight normal volunteers. Each subject underwent a standardized pancreatic function study which assessed nonstimulated secretion, the response to intrajejunal infusion of a mixture of amino acids, and the output following intravenous administration of secretin and cholecystokinin (CCK). In separate studies, the effect of a background infusion of bethanechol and secretin on the pancreatic response to CCK was assessed in six patients and six normal controls. Compared to normals, all diabetics exhibited a significant reduction in both enzyme and bicarbonate secretion to all stimuli. This reduction was not corrected by administering bethanechol. Plasma glucagon and pancreatic polypeptide levels in diabetics were not significantly higher than those in controls. We conclude that diabetics with diarrhea and peripheral neuropathy exhibit impairment of their exocrine pancreatic secretion and possible mechanisms for this are discussed.Keywords
This publication has 25 references indexed in Scilit:
- Cholinergic stimulation of human pancreatic secretionDigestive Diseases and Sciences, 1986
- Cholinergic component in the human pancreatic secretory response to intraintestinal oleate.Gut, 1983
- Regulation of biosynthesis of trypsinogen and chymotrypsinogen by nutritional and hormonal factors in the ratEuropean Journal of Clinical Investigation, 1981
- The pancreas as a single organ: the influence of the endocrine upon the exocrine part of the gland.Gut, 1981
- Effect of bovine pancreatic polypeptide on basal pancreatic and biliary outputs in manDigestive Diseases and Sciences, 1979
- Exocrine pancreatic function in juvenile-onset diabetes mellitus.Gut, 1976
- Pancreatic Exocrine Function in Maturity Onset Diabetes MellitusBMJ, 1973
- Effect of insulin on pancreatic amylase and chymotrypsinogenBiochemical and Biophysical Research Communications, 1965
- External Pancreatic Secretion in Diabetes MellitusAnnals of Internal Medicine, 1963
- The external secretion of the pancreas and diabetes mellitusDigestive Diseases and Sciences, 1943