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Clinical Manifestation

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Gastrointestinal Complications of Diabetes

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Diabetes is one of the most common chronic diseases and one of the leading causes of morbidity and mortality worldwide. Little is known about the correlation between diabetes and the pancreatobiliary tract. Diabetes mellitus and pancreatitis have complex relationships, with each serving as both a cause and a consequence of the other. The presence of diabetes not only increases the severity and worsens outcomes in acute pancreatitis; it is considered a risk factor for developing it. Post-pancreatitis diabetes is a novel disease entity, being increasingly recognized, which occurs even after one episode of pancreatitis. The mechanism underlying the association between diabetes mellitus and pancreatic cancer is complex, and probably involves immunological, hormonal, and metabolic changes which cause insulin resistance on one side and tumorogenesis on the other side. New onset of diabetes mellitus, especially in individuals with no predisposition, can be a first symptom of pancreatic cancer. Exocrine pancreatic insufficiency (EPI) is a commonly unrecognized complication not only associated with chronic pancreatitis but with a wide variety of conditions which can harm the pancreas. EPI in type 1 and 2 diabetes mellitus is fairly unrecognized although it has high prevalence. Type 3c diabetes mellitus is a separate condition caused by chronic pancreatic pathology such as chronic pancreatitis.

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Abbreviations

ANC:

Acute necrotic collections

AP:

Acute pancreatitis

BMI:

Body mass index

DM:

Diabetes mellitus

EPI:

Exocrine pancreatic insufficiency

FEC:

Fecal elastase-1 concentration

MetS:

Metabolic syndrome

NAFLD:

Non-alcoholic fatty liver disease

NAFPD:

Non-alcoholic fatty pancreas disease

NASH:

Non-alcoholic steatohepatitis

NASP:

Non-alcoholic steatopancreatitis

PDG:

Pancreatic duct gland

ROS:

Reactive oxygenation species

SIRS:

Systemic inflammatory response syndrome

WON:

Walled-off necrosis

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia

    Tajana Pavić, Dominik Kralj, Jelena Forgač, Davor Hrabar, Doris Ogresta, Vedran Tomašić & Ivan Lerotić

  2. University of Zagreb School of Medicine, Zagreb, Croatia

    Tajana Pavić, Dominik Kralj, Jelena Forgač, Davor Hrabar, Doris Ogresta, Vedran Tomašić & Ivan Lerotić

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  1. Tajana Pavić
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  2. Dominik Kralj
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Correspondence to Davor Hrabar .

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Editors and Affiliations

  1. Sestre milosrdnice University Hospital Center, University of Zagreb School of Medicine, Zagreb, Croatia

    Marko Duvnjak

  2. Merkur University Hospital, University of Zagreb School of Medicine, Zagreb, Croatia

    Lea Smirčić-Duvnjak

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Pavić, T. et al. (2018). Clinical Manifestation. In: Duvnjak, M., Smirčić-Duvnjak, L. (eds) Gastrointestinal Complications of Diabetes . Clinical Gastroenterology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-75856-5_17

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