In a previous study, mild to moderate exocrine pancreatic insufficiency, as measured by the secretin-pancreozymin test, was found in 23 (43%) of 53 patients with type-1 diabetes mellitus. Of these 53 patients, 20 (7 of whom initially had an abnormal secretin-pancreozymin test) were available for a follow-up examination 11 years later. Of the 7 patients with abnormal exocrine pancreatic function at the first test, 5 remained abnormal and 2 became normal, whereas of the 13 patients with initially normal pancreatic function the test result remained normal in 11 patients and became abnormal in 2. In these 2 groups the test result did not differ significantly between both tests. However, exocrine pancreatic function had returned to normal or had become abnormal in 2 patients, respectively, at the second test. In the 3 patients with exocrine pancreatic insufficiency at the first and second tests, the lipase level had not fallen below 10% or less than the normal level at which steatorrhea occurs and therapy is required. There was no significant correlation between the duration of the diabetes and the test results for both time points of investigation. The data suggest that mild to moderate exocrine pancreatic insufficiency found in type-1 diabetes is due to an early event in the course of the diabetes and does not progress. Therefore, this finding is of minor clinical importance and expensive pancreatic enzyme substitution will not be required.

Pollard HM, Miller L, Brewer WA: The external secretion of the pancreas and diabetes mellitus. Am J Dig Dis 1943;10:20–23.
Dreiling DA: Studies in pancreatic function. IV. The use of the secretin test in the diagnosis of tumors in and about the pancreas. Gastroenterology 1951;18:184–196.
Bartelheimer H, Ritter U: Das exkretorische Pankreas bei Diabetikern. Med Klin 1960;55:700–703.
Chey WY, Shay H, Shuman CR: External pancreatic secretion in diabetes mellitus. Ann Intern Med 1963;59:812–821.
Vacca JB, Henke WJ, Knight WA Jr: The exocrine pancreas in diabetes mellitus. Ann Intern Med 1964;61:242–247.
Domschke W, Tympner F, Domschke S, Demling L: Exocrine pancreatic function in juvenile diabetics. Am J Dig Dis 1975;20:309–312.
Frier BM, Saunders JHB, Wormsley KG, Bouchier IAD: Exocrine pancreatic function in juvenile-onset diabetes mellitus. Gut 1976;17:685–691.
Lankisch PG, Manthey G, Otto J, Koop H, Talaulicar M, Willms B, Creutzfeldt W: Exocrine pancreatic function in insulin-dependent diabetes mellitus. Digestion 1982;25:211–216.
Creutzfeldt W: Funktionsdiagnostik bei Erkrankungen des exokrinen Pankreas. Verh Dtsch Ges Inn Med 1964;70:781–801.
Lankisch PG, Schreiber A, Otto J: Pancreolauryl test. Evaluation of a tubeless pancreatic function test in comparison with other indirect and direct tests for exocrine pancreatic function. Dig Dis Sci 1983;28:490–493.
Lankisch PG, Creutzfeldt W: Effect of synthetic and natural secretin on the function of the exocrine pancreas in man. Digestion 1981;22:61–65.
DiMagno EP, Go VLW, Summerskill WHJ: Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. N Engl J Med 1973;288:813–815.
Lankisch PG, Lembcke B, Wemken G, Creutzfeldt W: Functional reserve capacity of the exocrine pancreas. Digestion 1986;35:175–181.
Gröger G, Layer P: Exocrine pancreatic function in diabetes mellitus. Eur J Gastroenterol Hepatol 1995;7:740–746.
Warren S, LeCompte PM: The Pathology of Diabetes Mellitus. Philadelphia, Lea & Febiger, 1952.
Tully GT, Lowenthal JJ: The diabetic coma of acute pancreatitis. Ann Intern Med 1958;48:310–319.
Henderson JR: Why are the islets of Langerhans? Lancet 1969;ii:469–470.
Williams JA, Goldfine ID: The insulin-pancreatic acinar axis. Diabetes 1985;34:980–986.
Lazarus SS, Volk BW: The effect of protracted glucagon administration on blood glucose and on pancreatic morphology. Endocrinology 1958;63:359–371.
El Newihi H, Dooley CP, Saad C, Staples J, Zeidler A, Valenzuela JE: Impaired exocrine pancreatic function in diabetics with diarrhea and peripheral neuropathy. Dig Dis Sci 1988;33:705–710.
Gamble DR, Taylor KW, Cumming H: Coxsackie viruses and diabetes mellitus. Br Med J 1973;i:289–290.
Kobayashi T, Nakanishi K, Kajio H, Morinaga S, Sugimoto T, Murase T, Kosaka K: Pancreatic cytokeratin: an antigen of pancreatic exocrine cell autoantibodies in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 1990;33:363–370.
Mally MI, Cirulli V, Hayek A, Otonkoski T: ICA69 is expressed equally in the human endocrine and exocrine pancreas. Diabetologia 1996;39:474–480.
Lankisch PG, Löhr-Happe A, Otto J, Creutzfeldt W: Natural course in chronic pancreatitis. Pain, exocrine and endocrine pancreatic insufficiency and prognosis of the disease. Digestion 1993;54:148–155.
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