The Exocrine Pancreas in Diabetes Mellitus

Article1 August 1964The Exocrine Pancreas in Diabetes MellitusJOSEPH B. VACCA, M.D., F.A.C.P., WILBERT J. HENKE, M.D., WILLIAM A. KNIGHT JR., M.D., F.A.C.P.JOSEPH B. VACCA, M.D., F.A.C.P., WILBERT J. HENKE, M.D., WILLIAM A. KNIGHT JR., M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-2-242 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptStudies of pancreatic exocrine function in patients with diabetes mellitus are few, and the results of these studies are inconclusive. Earlier investigators reported a high incidence of abnormal pancreatic function (1-5); more recently, however, Dreiling (6) and Akton and Klotz (7) noted normal pancreatic exocrine function in uncomplicated diabetes mellitus. This paper reports the results and significance of pancreatic exocrine function tests in a group of patients with diabetes mellitus.MATERIALS AND METHODSFifty-five patients were selected at random from the hospital wards and diabetic clinic. All patients met a minimum requirement of a blood sugar concentration (Folin-Wu) of 140...References1. JONESCASTLEMULHOLLANDBAILEY CMWHF: Pancreatic and hepatic activity in diabetes mellitus. Arch. Intern. Med. (Chicago) 35: 315, 1925. CrossrefGoogle Scholar2. AGRENLAGERLOFBERGLUND GHH: The secretin test of pancreatic function in the diagnosis of pancreatic disease. Acta Med. Scand. 90: 224, 1936. CrossrefGoogle Scholar3. DIAMONDSIEGLE JS: The secretin test in the diagnosis of pancreatic disease with a report of one hundred thirty tests. Amer. J. Dig. Dis. 7: 435, 1940. CrossrefGoogle Scholar4. POLLARDMILLERBREWER HLW: A clinical study of the secretin test. Amer. J. Dig. Dis. 9: 68, 1942. CrossrefGoogle Scholar5. POLLARDMILLERBREWER HLW: External secretion of the pancreas and diabetes (study of secretin test). Amer. J. Dig. Dis. 10: 20, 1943. CrossrefGoogle Scholar6. DREILING D: Studies in pancreatic function IV. The use of the secretin test in the diagnosis of tumors in and about the pancreas. Gastroenterology 18: 184, 1951. CrossrefMedlineGoogle Scholar7. AKTONKLOTZ HA: Fat absorption and pancreatic function in diabetes mellitus. Ann. Intern. Med. 49: 820, 1958. LinkGoogle Scholar8. HENKEVACCAVAN GOIDSENHOVENKNIGHT WJJBGEWA: Evaluation of pancreatic function tests in confirmed pancreatic disease. Gastroenterology 41: 233, 1961. CrossrefMedlineGoogle Scholar9. CECIL R: A study of the pathological anatomy of the pancreas in ninety cases of diabetes mellitus. J. Exp. Med. 11: 266, 1909. CrossrefMedlineGoogle Scholar10. GIBBLOGAN WV: Diabetes mellitus, a study of 147 autopsies. Arch. Intern. Med. (Chicago) 43: 377, 1929. CrossrefGoogle Scholar11. WARRENLE COMPTE SP: The Pathology of Diabetes Mellitus, Lea & Febiger, Philadelphia, 1952. Google Scholar12. LAZARUSVOLK SSBW: Pancreas in maturity-onset diabetes. Arch. Path. (Chicago) 71: 44, 1961. MedlineGoogle Scholar13. SOMOGYI M: Blood diastase in health and diabetes. J. Biol. Chem. 134: 315, 1940. CrossrefGoogle Scholar14. GRAYPROBSTEINHEIFETZ SHJGCL: Clinical studies on blood diastase, I. Low blood diastase as an index of impaired hepatic function. Arch. Intern. Med. (Chicago) 67: 805, 1941. CrossrefGoogle Scholar15. REIDMYERS EVC: Studies on animal diastase, IV. The effect of insulin on the diastase activity of the blood in diabetes. J. Biol. Chem. 99: 607, 1933. CrossrefGoogle Scholar16. HARDY JT: Cinical use of the secretin test. USAF Med. J. 11: 1248, 1960. Google Scholar17. BURTONHAMMONDHARPERHOWATSCOTTVARLEY PEMAAHTJEJ: Serum amylase and lipase levels in man after administration of secretin and pancreozymin. GUT 1: 125, 1960. CrossrefMedlineGoogle Scholar18. CHEYSHAYSHUMAN WYHC: External secretory function of pancreas in diabetes mellitus. Gastroenterology 40: 670, 1961 (Abstract). Google Scholar19. BARTHOLOMEWCOMFORT LGMW: Chronic pancreatitis without pain. Gastroenterology 31: 727, 1956. CrossrefMedlineGoogle Scholar20. EFFERSE P: Mild chronic pancreatitis: Chronic pancreatitis without severe acute exacerbations, bulky steatorrhea or pronounced weight loss. Acta Med. Scand. 165: 115, 1959. CrossrefMedlineGoogle Scholar21. FITZGERALD O: Clinical and other considerations in the diagnosis of chronic pancreatic disease. J. Irish Med. Ass. 47: 57, 1960. MedlineGoogle Scholar22. MUETHERKNIGHT ROWA: Chronic recurrent pancreatitis I. Clinical and laboratory aspects. Gastroenterology 12: 24, 1949. CrossrefMedlineGoogle Scholar23. MAIMONKIRSNERPALMER SNJBWL: Chronic recurrent pancreatitis. A clinical study of twenty cases. Arch. Intern. Med. (Chicago) 81: 56, 1948. CrossrefGoogle Scholar24. COMFORTGAMBILLBAGGENSTOSS MWEEAH: Chronic relapsing pancreatitis: A study of twenty-nine cases without associated disease of the biliary or gastrointestinal tract. Gastroenterology 6: 239 and 376, 1946. MedlineGoogle Scholar25. SPRAQUE RG: Diabetes mellitus associated with chronic relapsing pancreatitis. Proc. Staff. Meet. Mayo Clin. 22: 553, 1947. MedlineGoogle Scholar26. MOSCHCOWITZ E: Relation of hyperplastic arteriosclerosis to diabetes mellitus. Ann. Intern. Med. 34: 1137, 1951. LinkGoogle Scholar27. FISHBERG AM: Hypertension and Nephritis, 5th edition, Lea & Febiger, Philadelphia, 1954, p. 287. Google Scholar28. MURRAYTHAL MJAP: The clinical significance of circulating pancreatic antibodies. Ann. Intern. Med. 53: 548, 1960. LinkGoogle Scholar29. HENKEVACCAVAN GOIDSENHOVENKNIGHT WJJBGEWA: Pancreatic function in cirrhosis of the liver. Amer. J. Dig. Dis. 8: 160, 1963. CrossrefGoogle Scholar30. DAVIES J: Essential pathology of Kwashiorkor, Lancet I: 3; 7, 1948. Google Scholar31. CHEYSHAYSHUMAN WYHCR: External pancreatic secretion in diabetes mellitus. Ann. Intern. Med. 59: 812, 1963. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: St. Louis, MissouriFrom the Gastrointestinal Disease Section, Department of Internal Medicine, St. Louis University School of Medicine, and St. Mary's Hospital, St. Louis, Missouri.This investigation was supported in part by a grant from A. H. Robbins Co., Inc., and training grant 2A-5149 from the National Institute of Arthritis and Metabolic Diseases, United States Public Health Service, Bethesda, Maryland.Requests for reprints should be addressed to Joseph B. Vacca, M.D., 3915 Watson Rd., St. Louis 9, Missouri. 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