Prospective study of physical, clinical and radiological profile of patients with pancreatic diabetes
Keywords:Pancreatic diabetes, Secondary diabetes, Abdominal pain, Pancreatic calculi
Background: Pancreatic diabetes (PD) is the unique kind of diabetes which is secondary to tropical pancreatitis. The present study was performed to elucidate the prevalence, clinical profile and underlying nutritional factors of secondary or pancreatic diabetes (PD) mellitus along with the role of exocrine failure in the absence of radiological evidence of calcification.
Methods: A total 891 diabetes mellitus patients who were attending the diabetes education and care clinic, Jabalpur from October 2013 to April 2015 were studied. Diagnosis of pancreatic diabetes was done on the basis of history of recurrent abdominal pain from an early age, history of chronic alcoholism, the presence of pancreatic calculi seen on plain abdominal X-ray, absence of gall stone or hyperparathyroidism and diabetes mellitus. A detailed history, glycemic and lipid parameters along with micro and macrovascular complications were studied in all the patients with pancreatic diabetes.
Results: Out of 891 diabetes patients, 3 (0.34%) were having pancreatic diabetes. Most of them belong to age group of 36-45 years. BMI was <19 kgm2 in all the patients. Chronic alcoholism was seen in all the patients with PD. All the patients were having uncontrolled diabetes (FPG > 200 mg/dl, PPG >320 mg/dl and HbA1c > 8.5%). All three patients had retinopathy and peripheral neuropathy problem. Macrovascular complications were less present.
Conclusions: The prevalence of pancreatic diabetes was 0.34%, usually occurs in men with 3rd decade of age, low BMI and low socioeconomic status. Patients usually have uncontrolled diabetes (high FPG, PPG and HbA1c). Abdominal pain was the most common presenting symptom in patients. Microvascular complication was present in all the patients with pancreatic diabetes.
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