A Systematic Review of Exocrine Pancreatic Insufficiency Prevalence and Treatment in Type 1 and Type 2 Diabetes

Lewis, Dana

doi:10.1089/dia.2023.0157

Cited by 8 publications

(8 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other clinical diagnoses within which EPI may occur include trauma, critical illness, celiac disease, gastroparesis, human immunodeficiency virus, and inflammatory bowel disease 11 . The prevalence of EPI in those with diabetes mellitus (DM) has also been documented 12 …”

Section: Exocrine Pancreatic Insufficiencymentioning

confidence: 99%

“…Recent attention and research have focused on the intersection between DM and EPI. One systematic review examined the prevalence of EPI in patients with type 1 and type 2 DM by measurement of FE‐1 12 . They summarized that the prevalence of EPI is 14%–77.5% and 16.8%–49.2% in people with type 1 DM and type 2 DM, respectively, compared with that of the non‐DM control groups, which was at 4.4%–18% 12 .…”

Section: Disease States With High Risk For Epimentioning

confidence: 99%

“…One systematic review examined the prevalence of EPI in patients with type 1 and type 2 DM by measurement of FE‐1 12 . They summarized that the prevalence of EPI is 14%–77.5% and 16.8%–49.2% in people with type 1 DM and type 2 DM, respectively, compared with that of the non‐DM control groups, which was at 4.4%–18% 12 . It warrants mentioning that the American Diabetes Association considers a separate subgroup beyond type 1 and type 2 diabetes as pancreatogenic diabetes, or type 3c, which stems from diseases of the exocrine pancreas 28 .…”

Section: Disease States With High Risk For Epimentioning

confidence: 99%

See 2 more Smart Citations

Exocrine pancreatic insufficiency and pancreatic exocrine replacement therapy in clinical practice

Berry,

Bilbo

2024

Nut in Clin Prac

View full text Add to dashboard Cite

Exocrine pancreatic insufficiency (EPI) is a complex condition that disrupts normal digestion and absorption. Patients with EPI may suffer from mild to debilitating malabsorption with a constellation of symptoms that can have a significant effect on quality of life and nutrition status. Pancreatic enzyme replacement therapy (PERT) is effective and safe to treat EPI and is the standard of care for this condition. A wide variety and various forms of these products exist, as well as numerous guidelines and recommendations. Obtaining PERT for patients can oftentimes be cost prohibitive. Determining the presence and extent of EPI can be challenging and patient specific, making it difficult for practitioners. This narrative review will explore these issues, as well as several disease states potentially affected by EPI, and review current management strategies.

show abstract

Section: Exocrine Pancreatic Insufficiencymentioning

confidence: 99%

Section: Disease States With High Risk For Epimentioning

confidence: 99%

Section: Disease States With High Risk For Epimentioning

confidence: 99%

See 1 more Smart Citation

Exocrine pancreatic insufficiency and pancreatic exocrine replacement therapy in clinical practice

Berry,

Bilbo

2024

Nut in Clin Prac

View full text Add to dashboard Cite

show abstract

“…Exocrine pancreatic insufficiency (EPI) in T1D is common, present in approximately 33% of individuals versus 13% of the general population and is underdiagnosed. It is more common even than celiac disease or gastroparesis in the T1D population but is often forgotten when patients with T1D present with gastrointestinal complaints [ 54 ]. EPI clinically presents with symptoms of diarrhea or greasy stools, bloating, cramping, and/or weight loss.…”

Section: Diagnosis and Treatment Of Exocrine Pancreatic Insufficiency...mentioning

confidence: 99%

“…Once diagnosed, EPI can be treated with Pancreatic Enzyme Replacement Therapy (PERT). However, much research remains to be done regarding the impact of PERT treatment on glycemic indicators and optimization of PERT dosing in the T1D patient population [ 54 , 66 ].…”

Section: Diagnosis and Treatment Of Exocrine Pancreatic Insufficiency...mentioning

confidence: 99%

Type 1 Diabetes: A Disorder of the Exocrine and Endocrine Pancreas

Bruggeman,

Schatz

2023

J Cell Immunol

View full text Add to dashboard Cite

Type 1 diabetes has historically been described as an endocrine (β-cell) specific autoimmune disease. However, a substantial reduction (20-50%) in pancreas organ size and subclinical to symptomatic exocrine pancreatic insufficiency are present at diagnosis and may begin even prior to the development of islet autoimmunity. The mechanisms of exocrine loss in type 1 diabetes are not well understood, but leading hypotheses include developmental defects, β-cell loss resulting in exocrine atrophy, or autoimmune or inflammatory destruction of exocrine cells. Inflammatory changes including acute and chronic pancreatitis, exocrine T cell infiltration and classical complement activation, and serum exocrine autoantibodies within type 1 diabetes individuals suggest that an autoimmune or inflammatory process may contribute to exocrine pancreatic dysfunction. Exocrine pancreas atrophy primarily occurs prior to the onset of clinical disease. Indeed, recent work implicates exocrine-specific alterations in gene and protein expression as key in type 1 diabetes development. Measures of exocrine size and function could be useful additions in the prediction of disease onset and in identifying potential therapeutic responders to disease therapies, however, this is an underdeveloped area of research. Additionally, exocrine pancreatic insufficiency is underdiagnosed in individuals with type 1 diabetes and individualized treatment protocols are lacking. Much work remains to be done in this area, but we can definitively say that type 1 diabetes is a disorder of both the exocrine and endocrine pancreas likely from the start.

show abstract

Exocrine Pancreatic Insufficiency Dosing Guidelines for Pancreatic Enzyme Replacement Therapy Vary Widely Across Disease Types

Lewis,

Rieke,

Almusaylim

et al. 2023

Dig Dis Sci

View full text Add to dashboard Cite

A Systematic Review of Exocrine Pancreatic Insufficiency Prevalence and Treatment in Type 1 and Type 2 Diabetes

Cited by 8 publications

References 67 publications

Exocrine pancreatic insufficiency and pancreatic exocrine replacement therapy in clinical practice

Exocrine pancreatic insufficiency and pancreatic exocrine replacement therapy in clinical practice

Type 1 Diabetes: A Disorder of the Exocrine and Endocrine Pancreas

Exocrine Pancreatic Insufficiency Dosing Guidelines for Pancreatic Enzyme Replacement Therapy Vary Widely Across Disease Types

Contact Info

Product

Resources

About