Cs. Yajnik et Km. Shelgikar, FIBROCALCULOUS PANCREATIC DIABETES IN PUNE, INDIA - CLINICAL-FEATURESAND FOLLOW-UP FOR 7 YR, Diabetes care, 16(6), 1993, pp. 916-921
Citations number
27
Categorie Soggetti
Endocrynology & Metabolism","Medicine, General & Internal
OBJECTIVE- To study clinical features of fibrocalculous pancreatic dia
betes from this clinic, to compare these with the published criteria o
f malnutrition-related diabetes mellitus, and to conduct serial follow
-up of these patients to study difficulties in their treatment. RESEAR
CH DESIGN AND METHODS- Details of presenting symptoms, anthropometry,
diabetic tissue damage, treatment, and follow-up of 55 patients with f
ibrocalculous pancreatic diabetes (pancreatic calculi demonstrated on
X-ray and sonography) treated during the last 7 yr were studied. RESUL
TS - Many patients did not fit the accepted criteria of malnutrition-r
elated diabetes. Thus, 17 (31%) were diagnosed after 30 yr of age and
23 (42%) had a body mass index > 18 kg/m2, and the daily dose of insul
in in these patients (mean 0.8 U/kg) was similar to that in the IDDM p
atients (mean 1.0 U/kg). The two pathognomonic complaints (pancreatic
pain and steatorrhea) were not always present. Many patients took very
irregular treatment, but none suffered diabetic ketoacidosis despite
stopping insulin for long periods of time; 33% of patients had some di
abetic tissue damage when first seen. Fourteen patients were lost to f
ollow-up, and 11 died during the follow-up. CONCLUSIONS- Clinical feat
ures of these fibrocalculous pancreatic diabetes patients were somewha
t different than the classic descriptions. A need exists to reconsider
classification of FCPD under malnutrition-related diabetes mellitus.
Many patients receive irregular treatment, and a substantial proportio
n die within a few years of diagnosis, many as a result of preventable
causes.