diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12884diaendo-12884Research ArticleКлинический случайCase reportКлинический случай экзокринной недостаточности поджелудочной железы у пациентки с сахарным диабетом 1 типаA clinical case of exocrine pancreatic insufficiency in a patient with type 1 diabetes mellitushttps://orcid.org/0000-0002-4290-3182РагимовМ. Р.RagimovM. R.

Рагимов Магомедкерим Разинович – аспирант; Scopus Author ID: 57205098639

117036, Москва, ул. Дм. Ульянова, д. 11

Magomedkerim R. Ragimov - MD, PhD student

11 Dm. Ulyanova street, 117036 Moscow

tga.endocrine@gmail.comhttps://orcid.org/0000-0001-5656-2596НиконоваТ. В.NikonovaT. V.

Никонова Татьяна Васильевна - доктор медицинских наук; Scopus Author ID: 55553886600.

Москва

Tatiana V. Nikonova - MD, PhD; Scopus Author ID: 55553886600.

Moscow

tatiana_nikonova@mail.ruhttps://orcid.org/0000-0001-5283-3221МарченкоЕ. В.MarchenkoE. V.

Марченко Елена Владимировна, врач-гастроэнтеролог.

Москва

Elena V. Marchenko - MD.

Moscow

marchelle@mail.ruhttps://orcid.org/0000-0001-7321-9052МалышеваН. М.MalyshevaN. M.

Малышева Наталья Михайловна - кандидат биологических наук; Scopus Author ID: 57197834989.

Москва

Natalia M. Malysheva - PhD in Biology; Scopus Author ID: 57197834989.

Moscow

natalya.m@list.ruhttps://orcid.org/0000-0002-3222-6990ДеревянкоО. С.DerevyankoO. S.

Деревянко Ольга Сергеевна, кандидат медицинских наук; Scopus Author ID: 56095072000.

Москва

Olga S. Derevyanko - MD, PhD; Scopus Author ID: 56095072000.

Moscow

olgader14@mail.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian Federation2023100220232619397Copyright © Рагимов М.Р., Никонова Т.В., Марченко Е.В., Малышева Н.М., Деревянко О.С., 20232023Рагимов М.Р., Никонова Т.В., Марченко Е.В., Малышева Н.М., Деревянко О.С.Ragimov M.R., Nikonova T.V., Marchenko E.V., Malysheva N.M., Derevyanko O.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/12884

Поджелудочная железа (ПЖ) относится к железам смешанной секреции и выполняет одновременно и эндо-, и экзокринную функции. Экзокринная недостаточность ПЖ (ЭНПЖ) — это общее название процесса мальабсорбции, вызванного неадекватной продукцией и сниженной активацией ферментов ацинарных клеток ПЖ, таких как амилаза, липаза и протеаза, необходимых для пищеварения. Распространенность ЭНПЖ у пациентов с сахарным диабетом 1 типа (СД1), по данным множества авторов, варьирует от 25 до 59%, что определяется по данным панкреатической эластазы-1 (ПЭ-1). Внешнесекреторная недостаточность ПЖ зачастую может быть одной из причин эпизодов гипогликемии при СД1, особенно если ЭНПЖ ранее не была выявлена и пациент не получает заместительную ферментативную терапию. В данной работе мы представляем клинический случай подтвержденной ЭНПЖ у пациентки с 6-летним анамнезом СД1, ставшей причиной развития эпизодов постпрандиальной гипогликемии.

The pancreas belongs to the glands of mixed secretion and simultaneously performs both endo- and exocrine functions. Exocrine pancreatic insufficiency (EPI) is the general name for the malabsorption process caused by inadequate production and decreased activation of the enzymes of the pancreas acinar cells, such as amylase, lipase and protease, which are necessary for digestion. The prevalence of EPI in patients with type 1 diabetes, according to many authors, varies from 25 to 59%, which is determine by the data of pancreatic elastase-1. In this work, we present a clinical case of confirmed exocrine pancreatic insufficiency in a patient with a 6-year history of type 1 diabetes, which became the main cause of the development of episodes of hypoglycemia after meals. In the course of further studies, antibodies to lactoferrin and a reduced prostate volume, determined by MRI data, high levels of antibodies to glutamate decarboxylase and zinc co-transporter 8, as well as residual insulin secretion based on the level of C-peptide on an empty stomach detected.

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The authors declare that there are no conflicts of interest present.