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July 2007

Pancreatin for Diabetes

A study suggests that pancreatin may be beneficial as enzyme replacement therapy for patients with diabetes.

Researchers in Germany designed an investigation to evaluate the impact of enzyme-replacement therapy on glucose metabolism and diabetes treatment in a prospective study of insulin-treated patients with diabetes mellitus.

Recently, high prevalence of exocrine dysfunction in diabetic populations has been reported. Patients with fecal elastase 1 concentration (FEC) less than 100 micrograms/gram have also been demonstrated to suffer from steatorrhea in about 60 percent of cases, indicating the need of pancreatic enzyme replacement therapy.

Researchers mention that until now, there have only been a few reports on the use of enzyme replacement therapy in diabetic patients with exocrine pancreatic insufficiency.

The study observed a total of 546 patients with diabetes mellitus requiring insulin treatment, and they were screened for exocrine dysfunction by FEC measurements. One hundred and fifteen patients (21.1 percent) had FEC less than 100 micrograms/gram (normal is greater than 200 micrograms/gram). Of these, 95 patients entered the study and 80 patients were randomized to receive either pancreatin (Creon) or placebo in a double-blind manner.

During the observation phase of 16 weeks, there were no significant differences between both groups concerning HbA(1c), fasting glucose levels, 2-h pp glucose levels, clinical parameters and safety parameters.

The study observed a reduction in mild and moderate hypoglycemia in the pancreatin group at the end of the study.

The study concluded that pancreatin therapy can be used safely in patients with diabetes mellitus and exocrine dysfunction. Parameters of glucose metabolism were not improved by enzyme replacement therapy.


  1. Ewald N, Bretzel RG, Fantus IG, et al. Pancreatin therapy in patients with insulin-treated diabetes mellitus and exocrine pancreatic insufficiency according to low fecal elastase 1 concentrations. Results of a prospective multi-centre trial. Diabetes Metab Res Rev. 2007 Jul;23(5):386-91. View Abstract.
  2. Natural Standard Research Collaboration: The Authority on Integrative Medicine. Copyright 2007.
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