Chronic pancreatitis is one of the forms of the inflammatory process of the pancreas, which is characterized by a prolonged course of the disease, with the occurring irreversible changes in its cells and tissues. In severe chronic pancreatitis, a large percentage of the replacement of healthy organ tissue by fat or connective tissue is observed. As a result, both external secretory insufficiency, expressed in the lack of digestive enzymes, and intrasecretory dysfunction develops - it forms the body's initial tolerance to glucose, and then causes diabetes mellitus. This type of diabetes is often called pancreatic or symptomatic, arising as a symptom of a chronic pancreatic disease.
However, this mechanism is not a regularity. Many patients already suffering from type 1 or type 2 diabetes develop pancreatitis. And people with a diagnosis of chronic inflammation of the pancreas can avoid such a complication.
Mechanism of pancreatic diabetes development
The mechanism of symptomatic diabetes mellitus can be briefly characterized by a triad of syndromes - pain, digestive dysfunction, diabetes. And if this issue is approached in more detail, the pathological process proceeds according to the following scenario:
- The initial stage of pancreatitis with periods of remission and flare-ups of inflammation of the pancreas, accompanied by pain of varying intensity and localization, lasts about ten years.
- Then the symptomatic of disturbed digestion comes to the fore: flatulence, heartburn, diarrhea, loss of appetite. In the form of hypoglycemic conditions, a primary disorder of carbohydrate metabolism is manifested. This is due to insulin outbursts of irritated beta cells in patients with chronic pancreatic pancreatitis.
- As the processes of chronic pancreatitis spread, pancreatic cells are destroyed, and glucose tolerance is formed. The level of sugar in the bloodstream on an empty stomach is normal, and after eating it is too high, as is the permissible duration of hyperglycemia.
- The final stage is diabetes mellitus, which develops in more than 30% of patients with long-standing pancreatitis in the anamnesis. A similar disease of a different etiology is detected in patients twice as less.
Let's consider features of a diabetes mellitus at a chronic pancreatitis. Pancreatic diabetes is characterized by individual characteristics that distinguish it from other types:
- is often observed a sharp drop in glucose level in the bloodstream, resulting in the development of hypoglycemia;
- Ketoacidosis - a violation of carbohydrate metabolism caused by insulin deficiency, this symptom is not characteristic of the symptomatic type of the disease;
- The lesion of medium vessels and large arteries( macroangiopathy), as well as arterioles and capillaries( microangiopathy) is less common than in a similar type I or II disease;
- In the initial stage of the "sugar" disease, tablets that reduce glucose level are effective. In the future, this therapy is not effective. The need for insulin therapy is low;
- The disease is well treated with drugs of the sulfonylurea group, exercise and diet.
Pancreatitis in type 2 diabetes
Quite often against the background of pancreatitis is a disease such as type 2 diabetes, when the development of inflammation increases the blood glucose level. The development of this disease is accompanied by acute pain in the abdomen and a violation of digestive processes.
Specialists note several stages of the development of this disease:
- Pancreatitis exacerbation and remission( alternate with each other).
- Disorder of carbohydrate metabolism due to the fact that beta cells of the pancreas are irritated.
- The development of type 2 diabetes.
Approximately 35-40% of people, against pancreatitis, develop diabetes. Both diseases increase the influence of each other on the human body. In this regard, patients with pancreatitis in type 2 diabetes should not only undergo appropriate treatment, but also follow a diet.
Pancreas in diabetes mellitus
When the diabetes develops, the pancreas undergoes serious pathological changes. In this case, there is a dystrophic lesion of the islets of Langerhans. When there is deformation of the islets, the endocrine cells become smaller in size. In addition, a certain part of the cells die.
Two variants of pathological changes of pancreatic cells are possible. The first is the development of pancreatitis, and the second - the consequences become more sad, as the body completely ceases to function. This is due to the fact that in place of the cells that died, the connective tissue that squeezes normal cells grows, which leads to their death. It can be noted that diabetes mellitus can not only introduce destructive changes in the functioning of the pancreas, but also completely destroy this organ.
Treatment for pancreatitis and diabetes
In the event that a patient suffers from pancreatitis and diabetes at the same time, treatment is rather difficult. This is due to the fact that it is necessary to use substitution therapy not only to establish carbohydrate metabolism, but also to eliminate enzymatic deficiency. In this case, you need to use special enzymatic and hormone medications. It should be borne in mind that the use of tablets does not bring a positive result.
It is also very important in the treatment of pancreatitis and diabetes mellitus to adhere to proper nutrition, eliminating from the diet harmful to the pancreas products. Only if there are two factors - treatment and diet can effectively fight these diseases.
Diet for pancreatitis and diabetes
Pancreatitis and diabetes are diseases of the pancreas that require a strict diet. In this case it is extremely important to give up fatty and spicy food and to limit in their diet bakery products and sweets. In addition, meat broths, apples, cabbage, mayonnaise and sauces should not be eaten, since such food has an irritating effect on the intestinal epithelium.
In case if these two diseases occur simultaneously, experts recommend following the following diet:
- vegetables and fruits( 300-400 g.);
- refueling to food( 60 g.);
- protein food( 100-200 g.).
Compliance with the above diet will contribute to the fact that the pancreas will gradually restore its functions, and the patient's condition will stabilize. It is extremely important to conduct appropriate therapy of diseases.