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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

17 oral glucose tolerance tests with simultaneous estimation of plasma insulin, were carried out in 15 patients with chronic pancreatitis of which 7 were of calcific type. Among these patients, 10 had obvious diabetes and 3 chemical diabetes. The disorders of glucose regulation were more common in the calcific form of the disease. Serum insulin was then lower and not stimulant. The curves of plasma insulin obtained in non-calcific pancreatitis were variable. In hyperinsulinism, the oral glucose tolerance test showed flat or normal curves. In hypoinsulinism, the glucose tolerance tests were either normal or strongly pathological. This insulinism, as shown by this study of chronic pancreatitis, seems to be linked to an imbalance in the cell distribution of the islets of Langerhans. The role of glucagon appears preponderant.
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PMID:[Study of insulin secretion in chronic pancreatitis]. 18 95

The association of chronic pancreatitis with diabetes is not very common. Men are the usual victims and ethylism the usual cause. The most common age of onset is between 40 and 50. Insulin treatment is much more frequent than for idiopathic diabetics. Diabetic heredity is probable. Calcifying pancreatitis is the most frequent form. Micro and macroangiopathic complications are found. A statistical comparative study with a matched series of idiopathic diabetics reveals no difference in the onset of vascular complications. The rate of triglycerides is statistically lower in pancreatitis (p less than 0.001). The other biological rates are the same (cholesterol, uricemy, alpha 2 macroglobulin). Diabetic stability is no more difficult to obtain than for idiopathic diabetics. In most cases the diet should be wide and alcohol must be prohibited.
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PMID:[Diabetes and chronic pancreatitis. Report of twenty cases (author's transl)]. 23 6

N-benzoyl-L-tyrosyl-p-aminobenzoic acid (Bz-ty-PABA) was orally administered to 11 controls, 10 patients with chronic pancreatitis, 7 patients with diabetes mellitus and 6 patients with liver cirrhosis. The cumulative 6 h recovery rate of PABA in the urine was significantly lower (P less than 0.005) in patients with chronic pancreatitis (49.1 + or - 10.1 percent), diabetes mellitus (50.4 + or - 20.4 percent) and liver cirrhosis (52.5 + or - 13.0 percent) than in the control group (79.5 + or - 12.0 percent) (mean + or -S.D.). This test is considered to be useful in the diagnosis of pancreatic exocrine insufficiency, especially in chronic pancreatitis. Patients with diabetes mellitus frequently has demonstrable abnormality of pancreatic exocrine function. Liver cirrhosis causing severe impairment of liver functions seemed to interfer with the elimination of PABA.
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PMID:Study on the exocrine pancreatic function by the oral administration of N-benzoyl-L-tyrosyl-para-aminobenzoic acid. 30 23

A total of 61 pancreatectomies for chronic pancreatitis are reported. The operative mortality rate was 21% and the later mortality rate 29%, although caused by diabetes. The results are so poor that this method should only be performed in extreme situations. Left or right resection of the main inflammation site is proposed as an alternative. To prevent recurrence of the pancreatitis, the in situ remaining part of the pancreas should be sclerosed by occlusion of the pancreatic duct system.
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PMID:[Is total pancreatectomy still responsible treatment for chronic pancreatitis? (author's transl)]. 31 8

Total ligation of the pancreatic ducts of a normal gland in dogs and man results in atrophy of the acinar cells with preservation of islet cell function. Theoretically, this might be applied in the therapy of chronic pancreatitis since, in effect, an exocrine pancreatectomy results. Sustained islet cell function, as evidenced by a normal glucose tolerance test, following pancreatic duct ligation, was demonstrated in dogs for periods of up to two years. Resection of the head of the pancreas and ligation of the distal gland in six patients with chronic pancreatitis and an abnormal glucose tolerance test resulted in the development of insulin-dependent diabetes in all instances. Insulin-dependent diabetes was also demonstrated in one patient with a normal preoperative glucose tolerance test. Recurrent pancreatitis developed in only one patient. The study suggests that pancreatic duct ligation is effective in treating chronic pancreatitis but casts considerable doubt on the effectiveness of this procedure in preventing the development of diabetes, if the glucose tolerance test is abnormal
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PMID:Pancreatic duct ligation in the therapy of chronic pancreatitis. 38 Apr 23

All confirmed cases of pancreatic carcinoma in bona fida residents of Olmsted County, Minnesota, from 1935 through 1974 were identified and reviewed. The average annual age-adjusted incidence rates were 7.4 for males and 3.5 for females per 100,000 population. Rates increased with age for both sexes and increased slightly over the 40-year period of study, with lower incidence rates observed for rural inhabitants in the first 2 decades. At the time of diagnosis, almost 75% of patients were 60 years of age or older and adenocarcinoma was histologically identified in 92% of the cases. One-year survival was 11%, and all patients died within 3 years of the initial diagnosis. An association between pancreatic carcinoma and diabetes was noted. There does not appear to be a clear association with cholelithiasis or chronic pancreatitis. There was a high percentage (20%) of multiple primary carcinomas and an overrepresentation of metal workers observed among patients with pancreatic carcinoma.
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PMID:Cancer of the pancreas in Olmsted County, Minnesota, 1935-1974. 42 4

The authors report on 142 patients treated surgically for chronic pancreatitis. They had an average age of 43.5; 34.5% were calcific; 62.7% were alcoholics: 28.9% had cysts; 19% had diabetes; 16.9% had steatorrhea; and all had pain. A follow-up of 55 patients undergoing pancreaticojejunostomy showed that, 4--21 years following operation 16 had marked improvement, 11 had some relief, four were not relieved from pain, and 24 had died, three within one month postoperatively and 21 later. Eighty to ninety-five per cent pancreatectomy was more effective in relieving pain in the 9 patients subjected to this type of resection than was the 50--80% pancreatic resection used in 16 patients. Pancreaticoduodenectomy was of some value in three of five patients so operated. Celiac ganglionectomy, used in 22 patients, and sphincteroplasty, used in 35 patients, were less effective in relieving symptoms than the other procedures.
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PMID:Results of surgical treatment of chronic pancreatitis. Report of 142 cases. 42 54

In this review of the surgical experience with pancreatitis, 55 patients had acute relapsing pancreatitis associated with gallstones and 47 had chronic pancreatitis of alcoholic, idiopathic, or familial causation. The severity of pancreatitis associated with gallstones could not be correlated with results of preoperative biochemical tests; only one-third of patients were found to have stones within the biliary ductal system; and postoperative mortality (5%) could not be correlated with the severity of pancreatic inflammation or the timing of surgical intervention. Postoperative observations have revealed that all but four of the patients have remained asymptomatic. With regard to the patients with alcoholic, idiopathic, or familial disease who had significant pancreatic ductal dilatation or obstruction, ductal drainage procedures with or without resection benefited 80%. In the absence of ductal dilatation or obstruction, major resective surgery benefited 50% of patients. Continuing alcohol abuse limited the effectiveness of any operative procedure, and diabetes occurred more often after major resective procedures.
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PMID:Surgical treatment of pancreatitis: review of a series. 44 16

Intravenous infusion of porcine GIP in man induces insulin release when a degree of hyperglycemia is present. This glucose-dependent insulinotropic response occurs when a dose of GIP is administered to obtain circulating levels of approximately 1 ng/ml, a physiologic level that can be achieved by the ingestion of glucose or corn oil or a mixed meal. Serum GIP was measured by radioimmunoassay, and the single antiserum used in all the described studies measures 2 immunoreactive forms of GIP. In patients with chronic pancreatitis receiving an oral glucose load or mixed liquid test meal, GIP levels have been shown to be exaggerated. Similar elevated responses have been observed in obese patients and in maturity onset diabetes. A reduced GIP response has been seen in patients with celiac disease. A physiologic role for GIP in the enteroinsular axis has been established. However, involvement of the hormone in pathophysiologic situations is equivocal.
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PMID:Clinical studies with gastric inhibitory polypeptide. 51 74

This review describes the development and application of a novel test to determine levels of human immunoreactive trypsin, an enzyme produced solely by the pancreas, in biological fluids. Being organ-specific, the assay of immunoreactive trypsin should be an ideal marker of pancreatic function, and this is supported by the results of a number of clinical and research investigations. Use of this assay in studies of chronic pancreatitis, juvenile-onset diabetes, and cystic fibrosis has yielded much valuable data, and it is expected that further research will lead to an improved understanding of these and other conditions associated with the pancreas in health and disease.
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PMID:Radioimmunoassay of trypsin. A new aid in the assessment of pancreatic function. 51 80


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