Efficacy and Safety of Pancrelipase/Pancreatin in Patients With Exocrine Pancreatic Insufficiency and a Medical History of Diabetes Mellitus

Whitcomb, David C.; Bodhani, Amit; Beckmann, Katrin; Sander-Struckmeier, Suntje; Liu, Shufang; Fuldeore, Mahesh; Pollack, Paul; Khurmi, Rupal

doi:10.1097/mpa.0000000000000514

Cited by 24 publications

(16 citation statements)

References 31 publications

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“…Three small trials studied the efficacy of PERT in patients with diabetes mellitus secondary to chronic pancreatitis [90,91]. Treatment with PERT demonstrated a significant reduction in post-prandial plasma glucose and glycosylated hemoglobin at 6 months versus baseline values in patients with diabetes due to tropical calculous pancreatitis [92]. In contrast, PERT did not improve mean glucose values; it produced potentially life-threatening disturbances in glucose control among insulin-dependent diabetic patients due to chronic pancreatitis [93].…”

Section: Therapymentioning

confidence: 99%

Exocrine pancreatic insufficiency in type 1 and type 2 diabetes mellitus: do we need to treat it? A systematic review

et al. 2018

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The exocrine and endocrine pancreata are very closely linked both anatomically and physiologically. Abdominal symptoms such as nausea, bloating, diarrhea, steatorrhea, and weight loss can often occur in diabetic patients. Impairments of the exocrine pancreatic function seem to be a frequent complication of diabetes mellitus; however, they are largely overlooked. The aim of this paper is to provide an overview of the current concepts of exocrine pancreatic insufficiency (PEI) in diabetes mellitus. The prevalence and symptoms of PEI in diabetes mellitus, the pathomechanism, and difficulties of diagnosis and therapy of PEI are summarized in this systematic review.

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Section: Therapymentioning

confidence: 99%

Exocrine pancreatic insufficiency in type 1 and type 2 diabetes mellitus: do we need to treat it? A systematic review

et al. 2018

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“…2,3 CP may cause severe malnutritionand metabolic derangements if proper treatment is not provided. 4–8…”

Section: Introductionmentioning

confidence: 99%

Nutrition and Inflammatory Biomarkers in Chronic Pancreatitis Patients

Greer

Sandhu

et al. 2018

Nut in Clin Prac

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“…Pancreatic enzyme replacement therapy (PERT) is widely used in the treatment of chronic pancreatitis patients exhibiting PEI-associated symptoms and improves fat and protein absorption and serum nutritional parameters in a significant population of these patients [3,4]. Recent clinical trials have shown that PERT results in relief and improvement of PEI-associated symptoms in patients with chronic pancreatitis [5].…”

Section: Introductionmentioning

confidence: 99%

Supplementation of pancreatic digestive enzymes alters the composition of intestinal microbiota in mice

Nishiyama

Nagai

Kudo

et al. 2018

Biochemical and Biophysical Research Communications

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Although pancreatic enzyme replacement therapy (PERT) is effective in the alleviation of pancreatic exocrine insufficiency (PEI)-related symptoms in patients with chronic pancreatitis, its mechanism of action is poorly understood. Recent studies suggest that the intestinal microbiota is associated with the pathogenesis of chronic pancreatitis. Therefore, we hypothesized that PERT exerts its effect by modifying the intestinal microbiota in addition to its presumed role in promoting fat and protein absorption. To explore the mechanism of action of PERT, we analyzed the intestinal microbiotas of two groups of mice treated with either pancrelipase or tap water by using 16S rRNA amplicon sequencing. The results revealed that the bacterial compositions of the pancrelipase-treated mice were significantly different from those of the control samples. Akkermansia muciniphila, a key beneficial bacterium in the intestinal tract, showed a higher relative abundance in the pancrelipase-treated samples than in the control samples. Lactobacillus reuteri, a widely used probiotic bacterium known to relieve intestinal inflammation, also showed a higher relative abundance in the pancrelipase-treated samples. These results suggested that PERT induces the colonization of beneficial bacteria, thereby contributing to the attenuation of PEI-associated symptoms in addition to improvement of the nutritional state.

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Efficacy and Safety of Pancrelipase/Pancreatin in Patients With Exocrine Pancreatic Insufficiency and a Medical History of Diabetes Mellitus

Abstract: Pancrelipase improved fat and protein absorption in patients with EPI due to chronic pancreatitis or pancreatectomy, with or without DM, and matched the safety profile previously reported.

Cited by 24 publications

References 31 publications

Exocrine pancreatic insufficiency in type 1 and type 2 diabetes mellitus: do we need to treat it? A systematic review

Exocrine pancreatic insufficiency in type 1 and type 2 diabetes mellitus: do we need to treat it? A systematic review

Nutrition and Inflammatory Biomarkers in Chronic Pancreatitis Patients

Supplementation of pancreatic digestive enzymes alters the composition of intestinal microbiota in mice

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