Exocrine pancreatic insufficiency (EPI) may be more common in both type 1 and type 2 diabetes than is currently appreciated, a new literature review suggests.
The condition ― in which the pancreas fails to produce sufficient enzymes to fully digest food ― can cause gastrointestinal symptoms, including steatorrhea or other stool changes, bloating, and/or abdominal pain. The gold standard test for diagnosis is a 72-hour fecal fat quantification test, but fecal elastase-1 is a less invasive and reliable alternative; values of less than 200 Ig/g indicate EPI. Treatment is pancreatic enzyme replacement therapy (PERT), taken with every meal.
EPI occurs in up to 90% of people with cystic fibrosis and chronic pancreatitis and is commonly associated with acute pancreatitis, autoimmune pancreatitis, and pancreatic cancer. However, those conditions are relatively rare compared to diabetes, yet the EPI association with diabetes is less well-studied, Dana M. Lewis, BA, points out in her review article.
While the data vary across studies, owing to differences in inclusion and exclusion criteria, the overall median prevalence of EPI was 33% among patients with type 1 diabetes(range, 14% to 77.5%) and 29% among patients with type 2 diabetes (range, 16.8% to 49.2%), Lewis reports in the article, which was
