P-120: Exocrine pancreatic dysfunction in type 1 diabetes: association with glycemic control and disease duration
V S R Danda, A Elias, D A Reddy, V R Kankanti, B Kalava, V KyathamAbstract
Introduction
Type 1 diabetes(T1D) is recognized as a whole-pancreas disease involving both endocrine and exocrine pancreatic compartments. However, data on exocrine pancreatic dysfunction in type 1 diabetes remain limited, particularly from South Asia.
Objectives
To assess exocrine pancreatic dysfunction in type 1 diabetic patients and examine its association with glycemic control, disease duration, and pancreatic volume.
Methods
In this cross-sectional study, 60 individuals aged ≥15 years with T1D were evaluated. Fecal elastase-1 (FE-1) was measured to assess exocrine function. Pancreatic volume and pancreas volume index (PVI) were assessed using magnetic resonance imaging. Glycemic control was evaluated using HbA1c. Correlations were analysed using Pearson’s coefficient.
Results
Reduced fecal elastase-1 (<200 µg/g) was present in 21.7%. Mean fecal elastase was 241.5 µg/g, mean pancreatic volume 29.4 cm3, and mean PVI 0.57 cm3/kg. Fecal elastase showed a significant negative correlation with diabetes duration (r=-0.299, p=0.020).A strong negative correlation was observed between fecal elastase and HbA1c (r=-0.686, p<0.001). PVI also correlated negatively with diabetes duration (r=-0.492, p=0.0001). No significant correlation was seen between PVI and HbA1c or between fecal elastase and pancreatic volume.
Conclusions
Exocrine pancreatic insufficiency and reduced pancreatic volume are common in T1D. Exocrine dysfunction correlates with longer disease duration and poorer glycemic control, supporting the concept of T1D as a whole-pancreas disorder.