ArticleWorld journal of diabetes2025
Longitudinal assessment of pancreatic exocrine dysfunction in type 1 diabetes.
Article in World journal of diabetes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrevious studies have shown that individuals with type 1 diabetes (T1D) frequently present with reduced fecal elastase levels, suggesting exocrine pancreatic insufficiency. However, the underlying determinants and the longitudinal trajectory of these changes remain poorly understood.
aimTo evaluate longitudinal changes in fecal elastase among individuals with T1D, identify associated factors, and determine clinical implications.
methodsPancreatic exocrine function was evaluated in a cohort of patients with T1D by measuring fecal elastase concentrations (FECs). After a mean follow-up of 8.5 ± 0.5 years, participants were recontacted, and a second stool sample was obtained. At both time points, detailed medical histories were collected, including information on diabetes progression, metabolic control, complications, gastrointestinal symptoms, and nutritional status. The study was approved by the institutional ethics committee, and written informed consent was obtained from all participants.
resultsA total of 106 individuals with T1D (mean age = 46.2 years; 50% male) were enrolled. At baseline, the median FEC was 239.5 µg/g, with 44 participants (41.5%) demonstrating abnormally low levels (< 200 µg/g). Reduced fecal elastase was significantly associated with male sex, diabetes-related complications, particularly retinopathy, and higher glycated hemoglobin levels. No significant differences in gastrointestinal symptoms, body mass index, nor most serum nutritional markers were observed between individuals with normal
conclusionFecal elastase levels are frequently reduced in individuals with T1D and may show a gradual decline over time. The clinical impact of these changes appears to be limited.
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