Pancreatic exocrine insufficiency in diabetes mellitus

Shestakova, Marina Vladimirovna; Маев, И. В.; Аметов, А.С.; Antsiferov, M.B. Antsiferov; Bordin, D.S.; Galstyan, Gagik R.; Dzeranova, Larisa; Kucheryavy, Yu.A.; Mkrtumyan, А. M.; Nikonova, Tatiana Vasil'evna; Pashkova, E.Yu.

doi:10.14341/dm13027

Diabetes mellitus

2023

DOI: 10.14341/dm13027

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Pancreatic exocrine insufficiency in diabetes mellitus

Marina Vladimirovna Shestakova

И. В. Маев

А.С. Аметов

et al.

Abstract: Diabetes is disease of both the endo- and exocrine parts of the pancreas. Pancreatic exocrine insufficiency (PEI) can occur in every 2–3 patients with diabetes and affect not only the quality, but also life expectancy. At the same time, the diagnosis and treatment of PEI is not getting enough attention. The endocrinologist, as the main specialist leading patients with diabetes, can diagnose and treat patients with pancreatic exocrine insufficiency and diabetes using adequate doses of pancreatic enzyme replacem… Show more

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2024

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Cited by 2 publications

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How a significant increase in survival in pancreatic cancer is achieved. The role of nutritional status and supportive care: A review

Zhukova,

Bordin,

Dubtsova

et al. 2024

J. Mod. Onco.

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Pancreatic cancer (PC) is a serious public health problem. The mortality rate of patients with PC remains one of the highest among cancers. Early diagnosis of PC is challenging, so it is often diagnosed in the later stages. Current treatment approaches, including surgery, neoadjuvant and adjuvant chemotherapy, chemoradiotherapy, and supportive care, have demonstrated improved outcomes. A significant problem remains exocrine pancreatic insufficiency (EPI) in patients with PC, which requires enzyme replacement therapy. However, this is not given due attention in the Russian literature. This review addresses the survival trends of patients with PC, current therapies, and enzyme replacement therapy as an integral part of supportive care and improvement of nutritional status; also, the issues of routing patients with PC are addressed. It is emphasized that the diagnosis and treatment of EPI are mandatory to improve and maintain the nutritional status and quality of life; failure to treat EPI renders antitumor treatment ineffective.

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How a significant increase in survival in pancreatic cancer is achieved. The role of nutritional status and supportive care: A review

Zhukova,

Bordin,

Dubtsova

et al. 2024

J. Mod. Onco.

Self Cite

View full text Add to dashboard Cite

show abstract

Role of enzyme replacement therapy for exocrine and nutritional insufficiency in patients with malignancies: A review

Khatkov,

Maev,

Bordin

et al. 2024

J. Mod. Onco.

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Exocrine pancreatic insufficiency (EPI) is a condition in which the amount of secreted pancreatic enzymes is insufficient to maintain normal digestion. EPI is a frequent complication of pancreatic or other malignancies. The presence of EPI in a cancer patient may be suggested by symptoms of maldigestion, malabsorption, and alteration of nutritional markers; however, it is important to note that the EPI symptoms may be subtle. In the early stages, EPI may be latent and manifested by malnutrition. However, even in the later stages, the symptoms of EPI may be similar to those of cancer or be masked by the condition after chemoradiation therapy. Antitumor therapy itself may also cause EPI. Enzyme replacement therapy (ERT) is the standard of care for EPI, but it is rarely prescribed to cancer patients. However, supportive therapy plays an essential role in treating cancer patients because the quality of life and life expectancy of patients largely depend on the adequacy of the complex treatment. The review discusses the possible causes of EPI and its diagnosis and treatment in cancer patients. Special attention is paid to ERT regimens, including those for improving digestion and the drug's dosage form. It is shown that pancreatin in minimicrospheres is the drug of choice for ERT, since the minimum particle size facilitates the most physiological digestion process.

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Pancreatic exocrine insufficiency in diabetes mellitus

Cited by 2 publications

References 52 publications

How a significant increase in survival in pancreatic cancer is achieved. The role of nutritional status and supportive care: A review

How a significant increase in survival in pancreatic cancer is achieved. The role of nutritional status and supportive care: A review

Role of enzyme replacement therapy for exocrine and nutritional insufficiency in patients with malignancies: A review

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