Challenges in diagnosis and management of diabetes in the. Fibrocalculous pancreatic diabetes is an uncommon form of diabetes secondary to chronic nonalcoholic calcific pancreatitis found in tropical parts of the globe. Diabetes mellitus dm is a global health burden leading to significant morbidity and mortality in both young as well as elderly. Fibrocalculous pancreatic diabetes and macrovascular disease article in the journal of the association of physicians of india 49. Download pdf 464kb view article obesity km gadde, section editor. Presence of autoimmunity to pancreatic antigens in a. Spink1 is a susceptibility gene for fibrocalculous pancreatic diabetes in subjects from the indian subcontinent. Insulin deficiency plays a major role in the etiopathogenesis of fcpd.
Fibrocalculous pancreatic diabetescurrent scenario in developing. Fibrocalculous pancreatic diabetes, though classically described in the young, can occur in the middle aged, without a childhood history of abdominal pain, as shown in this rare case. Fibrocalculous pancreatic diabetes fcpd is a rare form of secondary diabetes which occurs due to chronic calcific pancreatitis in the absence of alcohol abuse and is mainly restricted to the. Fibrocalculous pancreatic diabetes in infancy two case. Some of the distinctive features of tcp are younger age at onset, presence of large intraductal calculi, more aggressive course of the disease, and a high susceptibility to pancreatic cancer. Fibrocalculous pancreatic diabetes is a unique entity wherein pancreatic calcification and chronic inflammation lead to exocrine and endocrine failure of the pancreas. Results longterm survival of patients with fibrocalculous pancreatic diabetes is much better today than that described 30 years ago. Assessment of insulin sensitivity and secretion in. Secular trends of fibrocalculous pancreatic diabetes and diabetes secondary to alcoholic chronic pancreatitis at a tertiary care diabetes centre in south india. Pdf spink1 is a susceptibility gene for fibrocalculous.
Volume 12 original research assessment of insulin sensitivity and secretion in patients with fibrocalculous pancreatic diabetes. Rozario papita, adamsha nazir, viknesh prabu anbalagan, ranjit mohan anjana, capecomorin pitchumoni, suresh chari, viswanathan mohan. The association of malnutrition and diabetes was first documented by zuidema in 1959 from indonesia. Moreover, druginduced diabetes and genetic forms of diabetes would spread out heterogeneously among the different clusters.
Fibrocalculous pancreatic diabetes fcpd is a form of diabetes secondary to chronic pancreatitis that is found in tropical countries. The classical triad of tcp consists of abdominal pain, steatorrhoea, and diabetes. The patients generally have clinical triad of pain abdomen, steatorrhoea and diabetes. Secular trends of fibrocalculous pancreatic diabetes and.
Fibrocalculous pancreatic diabetes mellitus fcdp is a unique form of. Pdf fibrocalculous pancreatic diabetes is a form of diabetes secondary to chronic pancreatitis found in. Fibrocalculous pancreatic diabetes fcpd is a form of diabetes secondary to tropical calcific pancreatitis tcp. Fibrocalculous pancreatopathy fcpp is a secondary form of diabetes mellitus of unresolved etiology that has historically been considered an issue specific to the impoverished agricultural tropics of india, but also occurs in the countries of bangladesh, china, and ethiopia. Fibrocalculous pancreatic diabetes fcpd remedy publications. Tropical chronic pancreatitis tcp is a juvenile form of chronic calcific nonalcoholic pancreatitis, seen almost exclusively in the developing countries of the tropical world. Prevalence of fibrocalculous pancreatic diabetes in chennai in south india article pdf available in jop. Prevalence of fibrocalculous pancreatic diabetes in. Objective to compare the secular trends in the prevalence of fibrocalculous pancreatic diabetes fcpd and diabetes secondary to alcoholic chronic pancreatitis acp at a diabetes centre in south india. Emerging concepts in the pathogenesis of diabetes in. Fibrocalculous pancreatitis diabetes fcpd, a secondary form of. Fibrocalculous pancreatic diabetes fcpd is seen mainly in young and malnourished individuals belonging to tropical and developing countries.
Bernhard radlinger, gabriele ramoser, susanne kaser article. The usual age of onset of fcpd is between 15 and 50 years. The recommended way of measuring plasma glucose and the threshold used to define what is normal or abnormal have gone through several iterations over the past few decades. Fibrocalculous pancreatic diabetes is an infrequent type of secondary diabetes due to chronic tropical non alcoholic calcific pancreatitis. The diagnosis and management of diabetes in youth presents several unique challenges. Context data on prevalence and trends in diabetes secondary to chronic pancreatitis in developing countries is scarce. Diabetes mellitus, chronic pancreatitis, fibrocalculous.
Tropical chronic pancreatitis postgraduate medical journal. These recommendations, and the current definitions of diabetes mellitus and. Objective this paper reports on prevalence of fibrocalculous pancreatic diabetes in chennai in south india based on the chennai urban rural epidemiology study. He was diagnosed to have diabetes mellitus since 2 years. Macrovascular disease is not that uncommon in fibrocalculous pancreatic diabetes partha s chattopadhyaya, jayanta mukhopadhyay, rita chattopadhyay, sanjib gupta diabetes care may 1994, 17 5 462463. Spink1psti mutations are associated with tropical pancreatitis. The median survival time after the diagnosis of diabetes was 25 years. Fibrocalculous pancreatic diabetes fcpd springerlink. Hassan zahid, mohan viswananthan, ali liaquat, allotey rebecca, barakat khalid, faruque m omar, deepa raj, mcdermott michael f, jackson alan e, cassell paul, et al.
This form of nonalcoholic pancreatopathy is exclusively seen among the young, with a male preponderance and commonly in tropical countries where malnutrition and poverty go hand. Four patients with fcpd who were obese are reported in this paper and this is the first report of obesity in fcpd patients. Limited data suggest a possible role of insulin resistance ir in the pathogenesis of fcpd. In the current classification, type 3 dm includes diabetes due to various secondary causes, and dm secondary to pancreatic exocrine dysfunction is placed in the type 3c subcategory. Pdf prevalence of fibrocalculous pancreatic diabetes in. The histopathology of fibrocalculous pancreatic diabetes fcpd has been extensively studied, but there are no reports on alteration in patterns of hormone secreting cells using immunohistochemistry in islets of fcpd patients.
Fibrocalculous pancreatic diabetes in a young female journal of. Current diabetes reports, volume 20, issue 6 springer. Chittaranjan s yajnik, sudha v kanitkar, kishore m shelgikar, sadanand s naik, k george m m alberti, derek hockaday. Objective to study clinical features of fibrocalculous pancreatic diabetes from this clinic, to compare these with the published criteria of malnutritionrelated diabetes mellitus, and to conduct serial followup of these patients to study difficulties in their treatment. He had a history of missing insulin doses frequently for extended periods and was.
While majority of patients have onset\ud of diabetes in youth childhood onset fcpd is less\ud common. A case of fibrocalculous pancreatic diabetes fcpd with. Hassan z, mohan v, ali l et al, spink1 is a susceptibility gene for fibrocalculous. It is associated with an increased risk of pancreatic carcinoma. Although type 1 diabetes is more common among children and adolescents, the incidence of type 2 diabetes in youth is also on the rise. Therefore a high index of suspicion is necessary in early diagnosis and treatment. Exocrine pancreatic insufficiency, as shown by low fecal chymotrypsin levels, was seen in 87. Exocrine pancreatic function in tropical fibrocalculous. Pancreatic cpeptide response to oral glucose in fibrocalculous pancreatic diabetes. The prevalence of diabetes in children and adolescents is increasing worldwide, with profound implications on the longterm health of individuals, societies, and nations. Fibrocalculous pancreatic diabetes and macrovascular. Fibrocalculous pancreatic diabetes in a young ugandan. The typical patient with fcpd is a lean adolescent or young adult of either sex, presenting with history of.
These findings provide evidence for autoimmunity to pancreatic antigens in a patient with fibrocalculous pancreatic diabetes. Pdf prevalence of fibrocalculous pancreatic diabetes in chennai. Fibrocalculous pancreatic diabetes fcpd is a form of diabetes secondary to tropical calcific pancreatitis usually affecting the poorer strata of society. The onset of diabetes usually follows the first few episodes of abdominal pain and develops by the second or third decade of life. Fibrocalcific pancreatic diabetes fcpd is a rare form of diabetes affecting people in the tropics and presenting with unique clinical and radiological features. Other forms of diabetes and its complications jj nolan and h thabit, section editors. Fibrocalculous pancreatic diabetes and obesity sciencedirect. This paper reports on two unusual cases of fcpd with age of onset below 5 years. A diagnosis is made basing on the presence of abdominal pain, presence of pancreatic calcifications, steatorrhoea, and diabetes mellitus. Histopathology and immunohistochemistry of pancreatic.
Diabetes mellitus represents a set of autoimmune, metabolic and genetic disorders that share one major characteristic hyperglycaemia. Fibrocalculus pancreatic diabetes in a young female. Journal of the pancreas secular trends of fibrocalculous pancreatic diabetes and diabetes secondary to alcoholic chronic pancreatitis at a tertiary care diabetes centre in south india. About 80% of patients were alive 35 years after the first episode of abdominal pain. Fibrocalculous pancreatic diabetes fcpd is an uncommon form of diabetes that occurs as a result of chronic calcific pancreatitis, in the absence of alcohol abuse. Fibrocalculous pancreatic diabetes fcpd is a\ud form of diabetes secondary to tropical chronic\ud pancreatitis. Research design and methods details of presenting symptoms, anthropometry, diabetic tissue damage, treatment, and. There is no population based data on prevalence of fibrocalculous pancreatic diabetes. Objective to determine the longterm survival and causes of death in fibrocalculous pancreatic diabetes, a form of diabetes secondary to tropical chronic pancreatitis.
The hallmarks of the disease are the occurrence of abdominal pain since childhood and pancreatic calculi associated with dilatation of the pancreatic duct and fibrosis. Fibrocalculous pancreatic diabetes fcpd request pdf. Context fibrocalculous pancreatic diabetes is a form of diabetes secondary to chronic pancreatitis found in tropical, developing countries. Most patients with fcpd are lean and many are frankly undernourished. Fibrocalculus pancreatic diabetes fcpd is a rare form of diabetes. Fibrocalculous pancreatic diabetes in a patient from bihar by s vidhya, g premalatha, v mohan and j s ravikumar download pdf 780 kb. Fibrocalculous pancreatic diabetes by v mohan and g premalatha download pdf 150 kb. Pancreatitis in fibrocalculous pancreatic diabetes mellitus is not associated with common mutations in the trypsinogen gene. When diabetes is present, the condition is called fibrocalculous pancreatic diabetes fcpd which is thus a later stage of tcp. Fcpd is one of the two forms of malnutrition related diabetes mellitus.
Pdf pancreatitis in fibrocalculous pancreatic diabetes. Four patients with fcpd who were obese are reported in this paper and. Fibrocalculous pancreatic diabetes fcpd is a secondary form of diabetes seen in patients with tropical chronic pancreatitis. It has been widely described exclusively in developing tropical countries.
Fibrocalculous pancreatic diabetes mellitus fcdp is a unique form of diabetes mellitus, which is secondary to chronic calcification of the pancreas in young nonalcoholic people and exclusively found in tropical countries. The disease is restricted to tropical regions of the world, and southern india has the highest known prevalence of fcpd. The association of malnutrition and diabetes was first documented by. Research design and methods a cohort of 370 patients with fibrocalculous pancreatic diabetes were analyzed with respect to survival time from the date of occurrence of the first symptom of the disease as well as after the onset of diabetes.
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