Gorelick F S
Yale J Biol Med. 1983 Jul-Aug;56(4):271-5.
Diabetes and carbohydrate intolerance can occur in pancreatitis. Although one-half of patients with acute pancreatitis will have some evidence of glucose intolerance during their acute illness, few will require insulin administration on either a short- or long-term basis. The diabetes seen in acute pancreatitis is likely due to a combination of factors, including alerted insulin secretion, increased glucagon release, and decreased glucose utilization by the liver and peripheral tissue. Chronic pancreatitis is often associated with diabetes mellitus, with the incidence as high as 70 percent when pancreatic calcification is present. These patients tend to be very sensitive to the effects of insulin and hypoglycemia. This is probably secondary to concurrent hepatic disease, malnutrition, and a relative decrease in glucagon reserves. The diabetes seen in chronic pancreatitis is associated with decreased insulin production. Finally, although the endocrine pancreas may influence the exocrine gland through a portal system, primary diabetes mellitus probably does not result in clinically significant alterations in pancreatic exocrine function.
糖尿病和碳水化合物不耐受可发生于胰腺炎。虽然一半的急性胰腺炎患者在急性发病期间会有一些糖耐量异常的证据，但很少有人需要短期或长期使用胰岛素。急性胰腺炎中出现的糖尿病可能是多种因素共同作用的结果，包括胰岛素分泌改变、胰高血糖素释放增加以及肝脏和外周组织对葡萄糖的利用减少。慢性胰腺炎常与糖尿病相关，当存在胰腺钙化时，发病率高达70%。这些患者往往对胰岛素和低血糖的作用非常敏感。这可能继发于并发的肝脏疾病、营养不良以及胰高血糖素储备相对减少。慢性胰腺炎中出现的糖尿病与胰岛素分泌减少有关。最后，虽然内分泌胰腺可能通过门静脉系统影响外分泌腺，但原发性糖尿病可能不会导致胰腺外分泌功能出现具有临床意义的改变。
