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Nutritional markers in patients with diabetes and pancreatic exocrine failure

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Abstract

Aims

Altered pancreatic exocrine function can be observed in patients with type 1 or type 2 diabetes. In the present study, we evaluated the potential nutritional consequences of this dysfunction.

Methods

Serum concentrations of nutritional markers, including albumin, cholesterol, triacylglycerol, vitamins A, D, and E, were assessed in a cohort of 468 patients (137 with type 1 diabetes and 331 with type 2 diabetes), after exclusion of the patients with a CRP > 10 mg/l. These patients were compared with 47 patients with diseases of the exocrine pancreas and diabetes (type 3c diabetes or pancreatogenic diabetes). Fecal elastase-1 and chymotrypsin concentrations were measured and patients with type 1 and type 2 diabetes were divided into three groups according to whether zero (group NN), one (group LN), or both (group LL) concentrations were decreased.

Results

Several markers differed significantly between the groups of patients, including BMI, albumin, phosphorus, and fat-soluble vitamins. Patients with pancreatogenic diabetes had markedly more profound alterations than patients with type 1 or type 2 diabetes and altered exocrine function. However, patients with type 1 or type 2 diabetes and decreased concentrations of both elastase-1 and chymotrypsin had lower albumin, phosphorus, and vitamin A than patients with normal pancreatic exocrine function.

Conclusions

Modest nutritional alterations were found in patients with type 1 or type 2 diabetes and altered exocrine function. Patients with type 1 or type 2 diabetes and altered exocrine function may thus deserve to be screened for nutritional deficiencies.

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Author information

Authors and Affiliations

  1. Service de Diabétologie, Hôpital Cochin, 123 Boulevard de Port-Royal, 75014, Paris, France

    Laure Alexandre-Heymann, Amal Y. Lemoine & Etienne Larger

  2. INSERM U 1016, Département Hospitalo Universitaire «AUTHORS», Université Paris Descartes, Paris, France

    Laure Alexandre-Heymann, Amal Y. Lemoine & Etienne Larger

  3. Laboratoire de Biochimie, Hôpital Cochin, Paris, France

    Samir Nakib

  4. Laboratoire de Coprologie Fonctionnelle, Hopital Pitié-Salpétrière, Paris, France

    Nathalie Kapel

  5. Université Paris Descartes, Paris, France

    Nathalie Kapel

  6. Service des Explorations Fonctionnelles, Hôpital Louis Mourier, Colombes, France

    Séverine Ledoux

  7. Université Denis Diderot, Paris, France

    Séverine Ledoux

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  1. Laure Alexandre-Heymann
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Correspondence to Etienne Larger.

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The authors declare that they have no conflict of interest. All investigations were performed in the context of routine patient’s care.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Alexandre-Heymann, L., Lemoine, A.Y., Nakib, S. et al. Nutritional markers in patients with diabetes and pancreatic exocrine failure. Acta Diabetol 56, 651–658 (2019). https://doi.org/10.1007/s00592-019-01294-w

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  • DOI: https://doi.org/10.1007/s00592-019-01294-w

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