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12 May 2020

Healthcare professionals urged not to ‘dismiss’ pancreatic exocrine insufficiency

Weight loss, abdominal pain, fatigue, diarrhoea and flatulence are all symptoms of a condition that has an “underlying cause” among those with type 2 diabetes.

Su Down, a Diabetes Nurse Consultant at the Somerset NHS Foundation Trust, has a specific interest in Pancreatic exocrine insufficiency (PEI).

She said: “What I find fascinating is the pancreas is just one organ that has two functions and they are looked after by different specialities – so if one of those functions stops working is not working well, it can impact on the other.”

The condition may be present in people with type 1 or type 2 diabetes. Alternatively, the condition which can develop in those who have suffered from chronic pancreatitis which comes under the umbrella of type 3c, can also lead to a diabetes diagnosis. The longer the duration of pancreatitis, the greater the chance of diabetes, occurring.

Su, who has more than 30 years’ experience under her belt, believes the condition very often goes unnoticed and if left untreated can lead to pancreatic carcinoma or pancreatic cancer.

She said: “It’s thought that about 30 percent of people with type 2 diabetes may actually have some sort of pancreatic insufficiency. In my experience type 3c is commonly misdiagnosed with type 2 diabetes.

“Only once someone has been correctly diagnosed can we start to explore treatment options such as pancreatic enzyme replacement therapy (PERT), which PERT has a positive impact on the symptoms of PEI in people with diabetes patients.

“Small studies have shown that PERT can benefit glycaemic control, as well as increasing insulin secretion and associated improvements in postprandial glucose levels, PERT may also reduce the frequency of hypoglycaemic episodes.”

Su has dedicated six years to PEI and has been asked to talk about the condition at DPC2020.

She said: “We really need to raise awareness of PEI as the condition can have a huge negative impact on someone’s health and mental wellbeing, so to be asked to speak at such a major diabetes conference is a huge honour.

“Despite the pandemic, healthcare professionals must bear PEI in mind when speaking to patients. Don’t just dismiss gastro problems as being down to metformin. Testing for pancreatic insufficiency is really very simple, so there’s no reason why more tests aren’t being carried out.”

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