One of the major complications of chronic pancreatitis is the development of diabetes mellitus. This can often be recognized based on the clinical features shown by the patient.


History suggesting pancreatic pathology:

(1) one or more episodes of acute pancreatitis

(2) one or more risk factors for pancreatitis (chronic alcohol abuse, chylomicronemia, other)

(3) pancreatic resection


Clinical findings:

(1) calcifications in the pancreas on abdominal X-ray

(2) steatorrhea that shows some response to administration of pancreatic enzymes

(3) usually thin body habitus


Features of the diabetes:

(1) multiple episodes of marked hypoglycemia, causing the patient to be viewed as "brittle"

(2) episodes of ketosis are uncommon

(3) progressive if the inciting cause persists (especially alcohol abuse)

(4) decreased serum insulin with a blunted response to glucose or other stimulants

(5) decreased serum glucagon


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