Abstract
The prevalence of exocrine pancreatic insufficiency in diabetes mellitus – a multicentre study
- Department of Gastroenterology and Internal Medicine, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
- Clinical Department of Internal Medicine, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
- Mossakowski Institute of Clinical Research, Polish Academy of Science, Warsaw, Poland
- Department of Gastroenterology and Hepatology with Endoscopy Unit, Medical University of Lublin, Poland
- Department of Digestive Tract Diseases, Medical University of Lodz, Poland.
- Department of Gastroenterology, Allergology and Pediatrics ICZMP of the Polish Maternal Memorial Hospital Research Institute, Lodz, Poland
- Department of Gastroenterology and Hepatology, Medical University of Gdansk, Poland
- Department of Surgical Oncology, Holy Cross Cancer Centre, Kielce, Poland
- Department of Surgery, Hospital of the Ministry of Interior and Administration, Kielce, Poland
- Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, Magdalenka, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
Gastroenterology Rev 2026; 21 (2): 160–165
Introduction
Faecal elastase-1 (FE-1) measurement is a widely utilised screening tool for exocrine pancreatic insufficiency (PEI).
Aim
The present study aimed to assess the prevalence of PEI in diabetic patients and its relationship with diabetes duration, antidiabetic medication use, body mass index, diabetes type, and comorbidities.
Material and methods
A retrospective study was conducted that included 519 patients with type 1 and type 2 diabetes from five medical centres in Poland. The ScheBo® Pancreatic Elastase-1 Quick™ test was utilised for the measurement of faecal elastase-1 levels. Patients with a history of alcohol abuse, gastrointestinal surgery, or pancreatic cancer were excluded from the study. The medical records of the patients were analysed to obtain clinical data.
Results
Among the 519 patients (262 women, 257 men; mean age: 67 years), 20.2% had an FE-1 level < 200 µg/g, indicating PEI. A statistically significant (p > 0.05) higher prevalence of PEI was observed in patients with obesity (BMI > 25 kg/m2). However, no statistically significant association was found between FE-1 levels and factors such as diabetes duration, antidiabetic medication use, or metabolic control. PEI is prevalent in diabetic patients, with a prevalence exceeding 20%. The findings of this study support the rationale for screening for FE-1 in diabetes and suggest that enzyme replacement therapy may be a viable treatment option for patients diagnosed with PEI.
Conclusions
The results of this study imply that PEI is not a late complication of diabetes but may occur independently of disease duration.
Keywords
faecal elastase-1, exocrine insufficiency, exocrine pancreatic insufficiency, diabetes mellitus, diabetic exocrine pancreatopathy, chronic pancreatitis
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