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el Newihi H, Dooley CP, Saad C, et al. Impaired exocrine pancreatic function in diabetics with diarrhea and peripheral neuropathy. Dig Dis Sci. 1988;33(6):705-10doi: 10.1007/BF01540434.
el Newihi, H., Dooley, C. P., Saad, C., Staples, J., Zeidler, A., & Valenzuela, J. E. (1988). Impaired exocrine pancreatic function in diabetics with diarrhea and peripheral neuropathy. Digestive diseases and sciences, 33(6), 705-10. https://doi.org/10.1007/BF01540434
el Newihi, H, et al. "Impaired exocrine pancreatic function in diabetics with diarrhea and peripheral neuropathy." Digestive diseases and sciences vol. 33,6 (1988): 705-10. doi: https://doi.org/10.1007/BF01540434
el Newihi H, Dooley CP, Saad C, Staples J, Zeidler A, Valenzuela JE. Impaired exocrine pancreatic function in diabetics with diarrhea and peripheral neuropathy. Dig Dis Sci. 1988 Jun;33(6):705-10. doi: 10.1007/BF01540434. PMID: 2897272.
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Dig Dis Sci. 1988 Jun;33(6):705-10. doi: 10.1007/BF01540434.

Impaired exocrine pancreatic function in diabetics with diarrhea and peripheral neuropathy.

Digestive diseases and sciences

H el Newihi, C P Dooley, C Saad, J Staples, A Zeidler, J E Valenzuela

Affiliations

  1. Department of Medicine, USC School of Medicine, Los Angeles 90033.

PMID: 2897272 DOI: 10.1007/BF01540434

Abstract

Exocrine pancreatic insufficiency has been observed in some diabetics with peripheral neuropathy and diarrhea. Several mechanisms may be responsible for this insufficiency: (1) pancreatic atrophy, (2) disruption of the cholinergic enteropancreatic reflexes, or (3) elevated serum levels of peptides such as glucagon and pancreatic polypeptide which are known to inhibit pancreatic exocrine secretion. To clarify the mechanism(s) involved in this exocrine pancreatic impairment, we studied 10 diabetics with diarrhea and peripheral neuropathy. Their results were compared to those of eight normal volunteers. Each subject underwent a standardized pancreatic function study which assessed nonstimulated secretion, the response to intrajejunal infusion of a mixture of amino acids, and the output following intravenous administration of secretin and cholecystokinin (CCK). In separate studies, the effect of a background infusion of bethanechol and secretin on the pancreatic response to CCK was assessed in six patients and six normal controls. Compared to normals, all diabetics exhibited a significant reduction in both enzyme and bicarbonate secretion to all stimuli. This reduction was not corrected by administering bethanechol. Plasma glucagon and pancreatic polypeptide levels in diabetics were not significantly higher than those in controls. We conclude that diabetics with diarrhea and peripheral neuropathy exhibit impairment of their exocrine pancreatic secretion and possible mechanisms for this are discussed.

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