Fibrocalculous pancreatic diabetes—current scenario in developing countries

Praveen, G; Mohan, Viswanathan

doi:10.1007/s13410-018-0638-x

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…The presentation of the disease, however, has become more heterogeneous, with only about 10–15% of patients presenting with the classical picture of FCPD. [20] Clinical characteristics in our study group showed that most (44%) of the patients presented with typical symptoms of diabetes mellitus, only one-third had abdominal pain and 24% had steatorrhea.…”

Section: Discussionmentioning

confidence: 76%

The clinical spectrum of fibrocalculous pancreatic diabetes in Kashmir valley and comparative study of the clinical profile of fibrocalculous pancreatic diabetes and type 2 diabetes mellitus

Bhat¹,

Bhat

Misgar

et al. 2019

Indian J Endocr Metab

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Background:Fibrocalculous pancreatic diabetes (FCPD) is a secondary form of diabetes, described from several tropical countries, including India. We described the existence of this entity in the subtropical region-the Kashmir valley of the Indian subcontinent and compared the clinical characteristics of these patients with type 2 diabetes mellitus (T2DM) patients.Aim:The present study aimed to compare the clinical characteristics of patients with FCPD and those with T2DM to identify the characteristics distinctive of FCPD.Materials and Methods:A total of 124 patients with FCPD were compared with 124 patients with T2DM matched for age and duration of diabetes. Biochemical parameters and microvascular and macrovascular complications were assessed in all patients. Multivariate regression analyses were performed to study the determinants of microvascular complications in both groups.Results:FCPD patients had significantly lower serum cholesterol, serum triglyceride, and serum calcium levels but higher glycosylated hemoglobin levels compared to T2DM patients. FCPD participants were significantly leaner. The prevalence of retinopathy, neuropathy, and nephropathy was similar between the two. Five T2DM patients had documented cardiovascular disease compared to one in FCPD patients (P < 0.05). Multiple logistic regression analysis revealed glycosylated hemoglobin and duration of diabetes to be significantly associated with retinopathy and nephropathy in T2DM. Among FCPD patients, glycosylated hemoglobin showed a strong association with retinopathy as well as nephropathy. BMI showed a significant negative association with nephropathy in FCPD patients. Age and age at onset showed a strong association with neuropathy in FCPD patients while the duration of diabetes showed the association with neuropathy (P = 0.015) in T2DM.Conclusion:There are several differences in the phenotype, biochemical parameters, and prevalence of diabetic complications between patients with FCPD and T2DM.

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Section: Discussionmentioning

confidence: 76%

The clinical spectrum of fibrocalculous pancreatic diabetes in Kashmir valley and comparative study of the clinical profile of fibrocalculous pancreatic diabetes and type 2 diabetes mellitus

Bhat¹,

Bhat

Misgar

et al. 2019

Indian J Endocr Metab

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show abstract

Section: Discussionmentioning

confidence: 99%

“…Other causes of chronic pancreatitis, such as hepatobiliary disease, alcoholism, and primary hyperparathyroidism, should carefully be excluded. 1,5,10,11 The pathogenesis and progression of FCPD remain poorly understood. 4 Multiple causes have been proposed, including malnutrition, dietary toxins present in cassava, genetic factors, autoimmune factors, and micronutrient deficiencies (such as vitamin C and D).…”

Section: Discussionmentioning

confidence: 99%

Non-tropical fibrocalculous pancreatic diabetes: case reports and review of recent literature

et al. 2020

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Background Fibrocalculous pancreatic diabetes (FCPD), an uncommon form of secondary diabetes, is caused by chronic nonalcoholic calcific pancreatitis and primarily occurs in tropical countries. Objective To present our first-hand experiences in the diagnosis and management of FCPD in two patients from a non-tropical location. Case report Two male Chinese patients (29 and 32 years old) presented with poor insulin function, negative islet cell and glutamate decarboxylase antibodies, and no spontaneous ketosis or abdominal pain. A careful clinical assessment was made and the results were correlated with laboratory findings. Abdominal ultrasound and computed tomography scans further revealed pancreatic calcification, calculi, and pancreatic duct dilation. Differential diagnosis confirmed FCPD and excluded the potential misdiagnosis of type 2 diabetes mellitus. FCPD in these patients was managed with insulin and symptomatic treatment with close monitoring. At the time of submission of this report, the first patient was stable at his last follow-up, but the second had been re-hospitalized for worsening symptoms. Conclusion Early differential diagnosis of FCPD based on clinical examination and biochemical and radiological investigations, in tandem with insulin therapy, can help manage FCPD effectively.

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“…These two diseases were described to have similar clinical features with people with FCPD having radiological evidence of pancreatic calcification. There have been numerous reports of FCPD or Tropical Calcific Pancreatitis (TCP) in settings of Africa and Asia (India) that are severely deprived (30,31). A recent study from a carefully selected group of male adults with low BMI diabetes and a history of malnutrition from India showed they had significantly lower measures of insulin resistance and beta cell function than those with overt type 2 diabetes (32).…”

Section: The Paradox Of Malnutrition-related Diabetes Mellitus (Mdrd)mentioning

confidence: 99%

The phenotype of type 1 diabetes in sub-Saharan Africa

Katte

McDonald

Sobngwi

et al. 2023

Front. Public Health

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The phenotype of type 1 diabetes in Africa, especially sub-Saharan Africa, is poorly understood. Most previously conducted studies have suggested that type 1 diabetes may have a different phenotype from the classical form of the disease described in western literature. Making an accurate diagnosis of type 1 diabetes in Africa is challenging, given the predominance of atypical diabetes forms and limited resources. The peak age of onset of type 1 diabetes in sub-Saharan Africa seems to occur after 18–20 years. Multiple studies have reported lower rates of islet autoantibodies ranging from 20 to 60% amongst people with type 1 diabetes in African populations, lower than that reported in other populations. Some studies have reported much higher levels of retained endogenous insulin secretion than in type 1 diabetes elsewhere, with lower rates of type 1 diabetes genetic susceptibility and HLA haplotypes. The HLA DR3 appears to be the most predominant HLA haplotype amongst people with type 1 diabetes in sub-Saharan Africa than the HLA DR4 haplotype. Some type 1 diabetes studies in sub-Saharan Africa have been limited by small sample sizes and diverse methods employed. Robust studies close to diabetes onset are sparse. Large prospective studies with well-standardized methodologies in people at or close to diabetes diagnosis in different population groups will be paramount to provide further insight into the phenotype of type 1 diabetes in sub-Saharan Africa.

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Fibrocalculous pancreatic diabetes—current scenario in developing countries

Cited by 6 publications

References 15 publications

The clinical spectrum of fibrocalculous pancreatic diabetes in Kashmir valley and comparative study of the clinical profile of fibrocalculous pancreatic diabetes and type 2 diabetes mellitus

The clinical spectrum of fibrocalculous pancreatic diabetes in Kashmir valley and comparative study of the clinical profile of fibrocalculous pancreatic diabetes and type 2 diabetes mellitus

Non-tropical fibrocalculous pancreatic diabetes: case reports and review of recent literature

The phenotype of type 1 diabetes in sub-Saharan Africa

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