Endocrine Abstracts

Objective: to analyze the dietary and metabolic factors predictive of the occurrence of pancreatitis in patients with type 1 diabetes mellitus (T1DM).

Patients and Methods: Analytical case-control study of 31 T1DM patients separated into two subgroups: G1 (n=10): T1DM cases with pancreatitis. G2 (n=21): T1DM controls without pancreatitis.

Results: The age at diagnosis of T1DM was comparable between the two groups. A discrete female predominance was noted in G1 (60% vs 38.1%; p>0.05). The mean BMI was higher in G2 (20.7±3.7 vs 22.9±4.2 kg/m^²; P=0.839). Controls had more android fat distribution (25% vs 14.3%; P>0.05). G1 T1DM had a higher calorie diet than G2 (2838.8±889.4 vs 2777.8±872.8 kcal/d; p>0.05) with higher intake of simple sugars (42.33±24.1 vs 33.5±35.2 g/d), calcium (558.3±177.7 vs 519.6±226.6 mg/d) but lower fibre (13.7±3.9 vs 17±6.3 g/d). The markers were similar except for phosphorus, which was significantly higher in G1 (1.13±0.41 vs 1±0.23 mmol/l); P=0.037)The dietary and metabolic factors aggravating the risk of pancreatitis in T1DM were associated with dyslipidemia (OR=3.3; P=0.000), the presence of a metabolic syndrome (OR=8.14; P=0.000), pre-existing microangiopathy (OR=3.84; P=0.013) and iterative diabetic keto-acidosis (OR=2.96; P=0.049).

Discussion: Prevention and treatment of dyslipidemia and metabolic syndrome are key to reducing the risk of pancreatitis in T1DM. Dietary management and physical activity remain the most effective.

References: 1. McClave, Stephen A., et al. "Nutrition support in acute pancreatitis: a systematic review of the literature." Journal of Parenteral and Enteral Nutrition 30.2 (2006): 143-156.

2. Lodewijkx, Piet J., et al. "Nutrition in acute pancreatitis: a critical review." Expert review of gastroenterology & hepatology 10.5 (2016): 571-580.