A high incidence of positive provocation of plasma pancreatic enzymes in the poorly controlled diabetic subjects.

Abnormal responses of plasma lipase, trypsin, and amylase to pancreozymin and secretin in poorly controlled diabetics were found in 42%, 41% and 30% while these responses in well controlled diabetics were 25%, 9% and 9% respectively. Positive provocation of at least one of these enzymes was observed in 67% of poorly controlled diabetics and was significantly more frequent than that (18%) in well controlled diabetics (p less than 0.01). An elevation of fasting lipase and amylase activities was also noted in 26% and 37% in the former in contrast to 0% and 18% in the latter. In the same 6 subjects the degree of abnormal plasma enzyme response was greater in the poorly controlled diabetic state than in the well controlled diabetic state. When insulin effect on plasma lipase response was tested in experimentally diabetic rats, insulin administration for 3 to 5 days normalized the abnormal provocation of lipase observed in chronically diabetic rats. These findings indicate that pancreatic enzymes tend to leak to the systemic circulation in insulin deficiency.