The prevalence of exocrine pancreatic insufficiency in diabetes mellitus – a multicentre study

Roland Kadaj-Lipka; Marta Wynimko; Karolina Borowska; Edward Franek; Agnieszka Mądro; Barbara Skrzydło‑Radomańska; Halina Cichoż­‑Lach; Barbara Włodarczyk; Ewa Małecka-Wojciesko; Elżbieta Czkwianianc; Krystian Adrych; Stanisław Głuszek; Dorota Kozieł; Grażyna Rydzewska

doi:10.5114/pg.2026.161673

eISSN: 1897-4317
ISSN: 1895-5770

Gastroenterology Review/Przegląd Gastroenterologiczny

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abstract:

Original paper

The prevalence of exocrine pancreatic insufficiency in diabetes mellitus – a multicentre study

Roland Kadaj-Lipka

¹

,

Marta Wynimko

²

,

Karolina Borowska

²

,

Edward Franek

^{2, 3}

,

Agnieszka Mądro

⁴

,

Barbara Skrzydło‑Radomańska

⁴

,

Halina Cichoż‑Lach

⁴

,

Barbara Włodarczyk

⁵

,

Ewa Małecka-Wojciesko

⁵

,

Elżbieta Czkwianianc

⁶

,

Krystian Adrych

⁷

,

Stanisław Głuszek

^{8, 9, 10}

,

Dorota Kozieł

¹¹

,

Grażyna Rydzewska

^{1, 11}

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

DOI: https://doi.org/10.5114/pg.2026.161673

Online publish date: 2026/05/14

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AMA

Kadaj-Lipka R, Wynimko M, Borowska K, et al. The prevalence of exocrine pancreatic insufficiency in diabetes mellitus – a multicentre study. Gastroenterology Review/Przegląd Gastroenterologiczny. 2026. doi:10.5114/pg.2026.161673.

APA

Kadaj-Lipka, R., Wynimko, M., Borowska, K., Franek, E., Mądro, A.,  & Skrzydło‑Radomańska, B. et al. (2026). The prevalence of exocrine pancreatic insufficiency in diabetes mellitus – a multicentre study. Gastroenterology Review/Przegląd Gastroenterologiczny. https://doi.org/10.5114/pg.2026.161673

Chicago

Kadaj-Lipka, Roland, Marta Wynimko, Karolina Borowska, Edward Franek, Agnieszka Mądro, Barbara Skrzydło‑Radomańska,  and Halina Cichoż‑Lach et al. 2026. "The prevalence of exocrine pancreatic insufficiency in diabetes mellitus – a multicentre study". Gastroenterology Review/Przegląd Gastroenterologiczny. doi:10.5114/pg.2026.161673.

Harvard

Kadaj-Lipka, R., Wynimko, M., Borowska, K., Franek, E., Mądro, A., Skrzydło‑Radomańska, B., Cichoż‑Lach, H., Włodarczyk, B., Małecka-Wojciesko, E., Czkwianianc, E., Adrych, K., Głuszek, S., Kozieł, D.,  and Rydzewska, G. (2026). The prevalence of exocrine pancreatic insufficiency in diabetes mellitus – a multicentre study. Gastroenterology Review/Przegląd Gastroenterologiczny. https://doi.org/10.5114/pg.2026.161673

MLA

Kadaj-Lipka, Roland et al. "The prevalence of exocrine pancreatic insufficiency in diabetes mellitus – a multicentre study." Gastroenterology Review/Przegląd Gastroenterologiczny, 2026. doi:10.5114/pg.2026.161673.

Vancouver

Kadaj-Lipka R, Wynimko M, Borowska K, Franek E, Mądro A, Skrzydło‑Radomańska B et al. The prevalence of exocrine pancreatic insufficiency in diabetes mellitus – a multicentre study. Gastroenterology Review/Przegląd Gastroenterologiczny. 2026. doi:10.5114/pg.2026.161673.

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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