Petrin P, Chiappetta A, Del Favero G, Farini R, Pedrazzoli S
Minerva Med. 1983 Jan 14;74(1-2):31-8.
Chronic pancreatitis appears to be increasing likely because increase in alcohol consumption and improved diagnostic tools. So the diabetes due to chronic pancreatitis is gaining importance. In order to obtain a better understanding of that particular secondary diabetes, 179 patients with chronic pancreatitis were studied from 1970 to 1981. 154 patients were male and 25 female. Average admission age was 45, ranging from 25 to 86. All the patients underwent medical therapy, based on diet, pancreatic enzymes, pain control. 99 of them underwent even to surgery. The follow-up is ranging from 6 months to 10 years: during this period 18 patients died, 41 went lost. 120 patients are still under observation. Diabetes was found in the family history of 27 patients (15%). At hospital admission 41 patients (23%) had high fasting glycemia, 23 of them even glycosuria. Other 74 showed diabetic oral glucose tolerance test. During the follow-up time 27 became clinically diabetic, 3 died because hyperosmolar coma and 8 had to be readmitted more than once because diabetic metabolic decompensation. Among the 120 patients at the moment under control, 66 (55%) show abnormal fasting glycemia, 10 developed high blood pressure, 12 inferior limbs vasculopathy with paresthesias and intermittent claudication, 2 myocardiosclerosis and atrial fibrillation, 1 myocardial infarction, 2 chronic nephropathy, 1 diabetic retinopathy. Whereas surgery or medic therapy may relieve chronic pancreatitis typical symptoms, they appear to be useless remedy against the under lying diabetes. As the time goes on more and more patients develop glucose intolerance, quite early became insulin-dependent, are disposed to severe diabetic metabolic decompensation and can show vascular, cardiac or renal complication.
慢性胰腺炎的发病率似乎在上升，这可能是由于酒精消费的增加和诊断工具的改进。因此，由慢性胰腺炎引起的糖尿病正变得越来越重要。为了更好地了解这种特殊的继发性糖尿病，1970年至1981年对179例慢性胰腺炎患者进行了研究。其中男性154例，女性25例。平均入院年龄为45岁，范围在25岁至86岁之间。所有患者均接受了基于饮食、胰酶、疼痛控制的内科治疗。其中99例甚至接受了手术治疗。随访时间为6个月至10年：在此期间，18例患者死亡，41例失访。120例患者仍在观察中。27例患者（15%）有糖尿病家族史。入院时，41例患者（23%）空腹血糖升高，其中23例甚至出现糖尿。另外74例患者口服葡萄糖耐量试验显示糖尿病。在随访期间，27例患者出现临床糖尿病，3例因高渗性昏迷死亡，8例因糖尿病代谢失代偿不得不多次入院。在目前接受治疗的120例患者中，66例（55%）空腹血糖异常，10例出现高血压，12例下肢血管病变伴感觉异常和间歇性跛行，2例心肌硬化和心房颤动，1例心肌梗死, 2例慢性肾病，1例糖尿病视网膜病变。虽然手术或内科治疗可能缓解慢性胰腺炎的典型症状，但它们似乎对潜在的糖尿病无效。随着时间的推移，越来越多的患者出现葡萄糖不耐受，很早就依赖胰岛素，容易发生严重的糖尿病代谢失代偿，并可能出现血管、心脏或肾脏并发症。
