The Prevalence and Characteristics of Exocrine Pancreatic Insufficiency in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Background. Exocrine pancreatic insufficiency (EPI) is common in patients with type 2 diabetes. However, the prevalence of EPI varies significantly in different studies. Untreated EPI in these patients can adversely affect their nutrition and metabolism. The aim of this study is to estimate the pool...

Full description

Saved in:
Bibliographic Details
Main Authors: Jun Zhang, Jiaying Hou, Dechen Liu, Yingqi Lv, Chi Zhang, Xianghui Su, Ling Li
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:International Journal of Endocrinology
Online Access:http://dx.doi.org/10.1155/2022/7764963
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849305128426799104
author Jun Zhang
Jiaying Hou
Dechen Liu
Yingqi Lv
Chi Zhang
Xianghui Su
Ling Li
author_facet Jun Zhang
Jiaying Hou
Dechen Liu
Yingqi Lv
Chi Zhang
Xianghui Su
Ling Li
author_sort Jun Zhang
collection DOAJ
description Background. Exocrine pancreatic insufficiency (EPI) is common in patients with type 2 diabetes. However, the prevalence of EPI varies significantly in different studies. Untreated EPI in these patients can adversely affect their nutrition and metabolism. The aim of this study is to estimate the pooled prevalence of EPI in patients with type 2 diabetes and to explore the potential risk factors. Methods. A systematic search was performed in PubMed, Web of Science, and Embase, which included studies meeting inclusion criteria from 1960 to 1 April 2022. Relevant articles were searched using the combination of Medical Subject Heading (MeSH) terms of “Type 2 diabetes” and “pancreatic exocrine insufficiency.” The Stata 16.0 software was used for data analyses. The random-effects model was used to estimate the pooled prevalence rates and 95% CI using “metaprop program.” Results. The pooled prevalence of EPI was 22% (95% CI: 15%–31%) in patients with type 2 diabetes and 8% (95% CI: 4%–14%) of them developed severe pancreatic insufficiency. In the subgroup analyses, the prevalence of EPI in type 2 diabetes was correlated with geographic location. The prevalence in Asian countries (35%, 95% CI: 22%–49%) is higher than in Europe (18%, 95% CI: 10%–29%) and Australia (9%, 95% CI: 4%–16%). Furthermore, patients with higher insulin requirements, who are more likely to be insulin-deficient, have a higher prevalence of EPI. The pooled prevalence was 27% (95% CI: 17%–37%) in type 2 diabetes with higher insulin requirement (1 group) and 15% (95% CI: 1%–40%) in patients with lower insulin requirement (2 group). In addition, the morbidity of severe EPI in the higher insulin requirement group (12%, 95% CI: 7%–19%) was sextuple as much as the lower insulin requirement group (2%, 95% CI: 0%–13%). EPI was more common in subjects younger than 60 compared with elderlies (25% vs. 19%). Conclusion. The prevalence of EPI in type 2 diabetes may be overestimated. Furthermore, the higher prevalence may be closely related to β-cell function. Endocrine disease therapy would potentially represent a novel therapeutic approach for patients with type 2 diabetes and EPI.
format Article
id doaj-art-3d249c2fe7ee46cdb256c9308fdb9fc4
institution Kabale University
issn 1687-8345
language English
publishDate 2022-01-01
publisher Wiley
record_format Article
series International Journal of Endocrinology
spelling doaj-art-3d249c2fe7ee46cdb256c9308fdb9fc42025-08-20T03:55:33ZengWileyInternational Journal of Endocrinology1687-83452022-01-01202210.1155/2022/7764963The Prevalence and Characteristics of Exocrine Pancreatic Insufficiency in Patients with Type 2 Diabetes: A Systematic Review and Meta-AnalysisJun Zhang0Jiaying Hou1Dechen Liu2Yingqi Lv3Chi Zhang4Xianghui Su5Ling Li6Department of EndocrinologyDepartment of EndocrinologyDepartment of EndocrinologyDepartment of EndocrinologyDepartment of EndocrinologyDepartment of EndocrinologyDepartment of EndocrinologyBackground. Exocrine pancreatic insufficiency (EPI) is common in patients with type 2 diabetes. However, the prevalence of EPI varies significantly in different studies. Untreated EPI in these patients can adversely affect their nutrition and metabolism. The aim of this study is to estimate the pooled prevalence of EPI in patients with type 2 diabetes and to explore the potential risk factors. Methods. A systematic search was performed in PubMed, Web of Science, and Embase, which included studies meeting inclusion criteria from 1960 to 1 April 2022. Relevant articles were searched using the combination of Medical Subject Heading (MeSH) terms of “Type 2 diabetes” and “pancreatic exocrine insufficiency.” The Stata 16.0 software was used for data analyses. The random-effects model was used to estimate the pooled prevalence rates and 95% CI using “metaprop program.” Results. The pooled prevalence of EPI was 22% (95% CI: 15%–31%) in patients with type 2 diabetes and 8% (95% CI: 4%–14%) of them developed severe pancreatic insufficiency. In the subgroup analyses, the prevalence of EPI in type 2 diabetes was correlated with geographic location. The prevalence in Asian countries (35%, 95% CI: 22%–49%) is higher than in Europe (18%, 95% CI: 10%–29%) and Australia (9%, 95% CI: 4%–16%). Furthermore, patients with higher insulin requirements, who are more likely to be insulin-deficient, have a higher prevalence of EPI. The pooled prevalence was 27% (95% CI: 17%–37%) in type 2 diabetes with higher insulin requirement (1 group) and 15% (95% CI: 1%–40%) in patients with lower insulin requirement (2 group). In addition, the morbidity of severe EPI in the higher insulin requirement group (12%, 95% CI: 7%–19%) was sextuple as much as the lower insulin requirement group (2%, 95% CI: 0%–13%). EPI was more common in subjects younger than 60 compared with elderlies (25% vs. 19%). Conclusion. The prevalence of EPI in type 2 diabetes may be overestimated. Furthermore, the higher prevalence may be closely related to β-cell function. Endocrine disease therapy would potentially represent a novel therapeutic approach for patients with type 2 diabetes and EPI.http://dx.doi.org/10.1155/2022/7764963
spellingShingle Jun Zhang
Jiaying Hou
Dechen Liu
Yingqi Lv
Chi Zhang
Xianghui Su
Ling Li
The Prevalence and Characteristics of Exocrine Pancreatic Insufficiency in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
International Journal of Endocrinology
title The Prevalence and Characteristics of Exocrine Pancreatic Insufficiency in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
title_full The Prevalence and Characteristics of Exocrine Pancreatic Insufficiency in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
title_fullStr The Prevalence and Characteristics of Exocrine Pancreatic Insufficiency in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
title_full_unstemmed The Prevalence and Characteristics of Exocrine Pancreatic Insufficiency in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
title_short The Prevalence and Characteristics of Exocrine Pancreatic Insufficiency in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
title_sort prevalence and characteristics of exocrine pancreatic insufficiency in patients with type 2 diabetes a systematic review and meta analysis
url http://dx.doi.org/10.1155/2022/7764963
work_keys_str_mv AT junzhang theprevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT jiayinghou theprevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT dechenliu theprevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT yingqilv theprevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT chizhang theprevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT xianghuisu theprevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT lingli theprevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT junzhang prevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT jiayinghou prevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT dechenliu prevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT yingqilv prevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT chizhang prevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT xianghuisu prevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis
AT lingli prevalenceandcharacteristicsofexocrinepancreaticinsufficiencyinpatientswithtype2diabetesasystematicreviewandmetaanalysis