What is The Role Of Pancreas In Diabetes

 Pancreatin for type 2 diabetes

Pancreatitis and diabetes often develop at the same time. The latter is a complicated endocrine illness defined by a disruption of all metabolic systems. Characteristics of diabetes progression in chronic pancreatitis

Pancreatic diabetes does not always develop with inflammation of the pancreas. But if that happened, it has a number of features.

Pancreatitis and diabetes often develop at the same time.

In chronic pancreatitis, endocrine disorders occur, which can occur both in the form of hypoglycemia and in a form such as pancreatogenic diabetes mellitus. Hypoglycemia occurs with all symptoms typical of the disease, which include a constant feeling of hunger, weakness, pain, convulsions, or tremors throughout the body.

As for diabetes, it is not a type 2 disease, but a separate variant of it, which is isolated in type 3.

For example, such diabetes often develops in people of normal or even slim build, and in itself has nothing to do with obesity. There is also no association with insulin resistance or genetic predisposition. The increase in blood sugar often happens almost imperceptibly.

Symptoms that appear several years after the first abdominal pain is associated with changes in a large number of pancreatic cells.

Features of pancreatogenic diabetes are:

• low insulin requirement;
• rare ketoacidosis;
• increased susceptibility to infectious and skin diseases.

Mechanism of transition of pancreatitis to diabetes

Pancreatitis and diabetes do not always develop at the same time. The pathway linking chronic pancreatitis (CP) to diabetes is poorly understood. There is a little more information about acute pancreatitis (OP) because it is easier to diagnose.

With exacerbation of chronic pancreatitis, transient hyperglycemia develops, which is associated with pancreatic edema.

Statistics show that transient hyperglycemia in such situations occurs in 50% of cases, but stable lasts only in 15% after transmitted OP ..

Along with the worsening of the chronic form of the disease, transient hyperglycemia also develops, which is associated with pancreatic edema.

At the same time, trypsin levels rise in the blood and it reduces insulin production. As the seizure progresses, blood glucose levels return to normal.

causes

The risk of developing diabetes does not depend on the degree of pancreatic necrosis, but on what methods of surgical treatment have been used. For example, with pancreatoduodenectomy, the probability of developing postoperative diabetes reaches 50%.

The following causes of type 3 diabetes are distinguished:

1. Chronic inflammation of the pancreas. It is caused by various factors, for example, lack of timely treatment of acute food poisoning, malnutrition, etc. The number of pancreatic enzymes, which destroy this organ, increases.
2. surgery.
3. Bad habits.
4. Being overweight as a result of malnutrition.
5. Other diseases of the pancreas and digestive tract, due to which endocrine function is impaired and blood glucose levels increase.

symptomatology

First, symptoms characteristic of pancreatic tissue damage appear:

• nausea without vomiting;
• frequent heartburn;
• bloating and bloating;
• epigastric pain;
• unstable stools, diarrhea or other digestive disorders.

This type of diabetes is mild. Tests show a relatively small increase in blood glucose. But there are often attacks of hypoglycemia. Over time, blood glucose begins to increase more intensely, there are already classic signs of diabetes, including constant thirst and dry skin.

Complications such as ketoacidosis or ketonuria are rare in this case. But complications from other organs can appear - diabetic neuropathy, impaired renal function, retinopathy.

Prevention and treatment of pancreatic diabetes

Therapy of chronic pancreatitis is carried out simultaneously with the treatment of diabetes. Includes the following parts:

• Dietary compliance. Since the disease is caused by metabolic disorders, it is necessary to adjust the diet so as to improve metabolism and eliminate hypovitaminosis and protein deficiency.
• Taking sugar-lowering medications. It is necessary to normalize carbohydrate metabolism, endo and exocrine system. To do this, take insulin - in small doses and for a short time, and then - sulfa drugs, for example, Diabeton.
• Postoperative replacement therapy, taking enzymes (eg pancreatin).
• Liver cell protection (prescribed Essential Forte).
• Autotransplantation of island cells.

Dietary rules for diseases

To avoid pathological changes in the cells of the pancreas of the body, it is necessary to completely eliminate a number of products ..

Products that can and can't

In addition to these diseases, the following are excluded from the diet:

• fatty meat;
• dairy products (cream, sour cream, full of fat in whole milk);
• any fast food;
• vegetables (radishes, garlic, onions, spinach);
• fruits - grapes, pineapple;
• legumes;
• spice;
• baking butter, chocolate, ice cream;
• ready-made sauces - mayonnaise, ketchup, soy sauce, tomato paste and even juice.

Forbidden rich fish and meat soup.

Plant nutrition

Sources of plant proteins are legumes. But with chronic pancreatitis they are banned, so a plant-based diet for these diseases is not prescribed.

Diet 9 for pancreatitis

Foods in which carbohydrates play the role of a natural preservative are excluded from the diet. These are bananas, dates, figs, tomatoes, grapes.

Sweet and sour berries and fruits are recommended - almost all citrus fruits (except grapefruit and lemon - contain too much acid), apples, kiwis, cherries, black currants, cranberries and lingonberries.

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Diet 5 for diabetes

Treatment table no. 5 according to M. Pevzner is prescribed for patients with chronic pancreatitis or pathologies of the hepatobiliary system. The main points are combined with the nutritional needs for diabetes:

1. Reduce fat intake, avoid fried, spicy, salty foods, canned meat and vegetables, smoked meats.
2. Adherence to cooking rules. Cooking, sautéing, steaming, baking without crust are allowed.
3. Food should be fractional, divided into 5-6 meals. With exacerbation of pancreatitis, all meals are served in liquid or semi-liquid form, with remission, cut into small pieces.
4. Food that increases intestinal motility is excluded, it is digested for a long time, it can cause fermentation - fresh bread, legumes, cabbage, etc ..

It is important to drink enough fluids - 1.5 liters of clean water without gas per day.

For diabetes, fried, spicy, spicy foods should be discarded.

A diabetes diet should be fractional, divided into 5-6 meals.

Sweet and sour berries and fruits are recommended to be included in the patient's diet.

It is important to drink enough fluids - 1.5 liters of clean water without gas per day.

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How to combine Tables 9 and 5?

This condition of the body, in which pancreatitis is accompanied by diabetes, requires a special approach to diet. But both therapeutic diets are quite close, suggesting a number of general rules and restrictions.

A few simple recipes

Proper nutrition plays an important role. But that doesn’t mean it should be monotonous. You can treat yourself to dessert from time to time.

Meat pudding

For cooking take lean meat, for example, beef - 150 g. It must be cooked and go through a meat grinder.

Also, for the pudding, you will need 1 egg, 1 tbsp. porridge, a little vegetable oil.

Semolina is pre-filled with boiled water (1/3 cup) so that it swells. Egg and spoon are added to the prepared minced meat, everything is mixed, salt to taste. Lubricate the mold with oil before placing it in the double boiler.

Vinaigrette

With pancreatitis, you can cook vinaigrette. You will need 100 g of potatoes, 90 g of beets, 60 g of carrots, 60 g of fresh cucumbers, salt to taste, 1 tbsp. cooking oil for topping.

Potatoes, beets, and carrots should be cooked separately from each other, cooled and cut into cubes. Peel a cucumber and cut it into cubes. You can add lettuce leaves if desired. The vegetables are mixed by adding salt and oil.

Dry porridge

For this dish, you will need 300 g of low-fat cheese and the same amount of apples, 2 eggs, 100 g of raisins, which are pre-washed and steamed in boiling water.

The apple must be peeled from the seeds and peeled, then grated in a small oven. Raisins, eggs and the resulting apple sauce are added to the curd mass, all thoroughly mixed, transferred to the parchment in the form and put in the oven, preheated to 180 ° C. Bake the cheese souffle for 40 minutes.

Bar drink

Prepare it from the dried fruits of this plant. Cooked immediately in a thermos. For 1 liter of boiling water, you need to take 4 tbsp. fruit. The drink is drunk for several hours. You can't add sugar to it.

Chronic pancreatitis and diabetes - two stages of the same disease?

Pancreatitis and diabetes are the two most serious diseases that go hand in hand. In this case, type 1 and 2 diabetes are often the results of advanced pancreatitis.

Prerequisite for the first symptoms of pancreatic disorders, in about 70%, is alcohol abuse, in 20% - liver disease, including gallstone complications, and in 10% - other causes, including regular eating disorders, stress, lack of rest, and individual reactions of the body to certain drugs and chemical compounds.

Early diagnosis and treatment of chronic pancreatitis is complicated by its gradual and rather slow development. Sometimes the process takes decades.

During this period, sharp cutting pains in the left hypochondrium are replaced by long drowsies during which the person feels healthy.

But this deceptive condition and any, even minor, eating disorders can cause acute inflammation of the pancreas, which over time turns into a chronic form.

Types of pancreatitis

The disease is found in acute and chronic forms ..

In the acute form, due to inflammation, the juice of the pancreas does not pass into the lumen of the duodenum but digests the tissues of the pancreas itself. This process causes necrotic changes in the cells of the diseased organ, and in particularly severe cases, the complete death of the entire gland.

Chronic pancreatitis, depending on the cause, is classified as follows:

• Primarily - it originally occurs in the pancreas for some reason.
• Secondary - is a consequence of diseases of other organs: cholecystitis, ulcers, enterocolitis.
• Post-traumatic - a consequence of mechanical stress or surgery.

The mechanism of diabetes

Type 1 and type 2 diabetes can arise from either form of the illness..

Type 1 diabetes mellitus, with pancreatitis, occurs due to the fact that inflamed pancreatic ducts do not pass digestive enzymes into the lumen of the duodenum 12 and only digestion begins, degeneration of cellular tissue into fatty, connective or complete death of organ fragments.

The body experiences an absolute lack of insulin, blood glucose levels increase, which has a destructive effect on all body systems.

Type 2 diabetes occurs with sufficient insulin production. But due to metabolic disorders, it does not fulfill its main function, creating a relative insufficiency.

Pathological changes accumulate over time and are divided into four stages:

1. In the first stage, short-term exacerbations are intertwined with long drowsiness. Chronic inflammation develops in the gland, which is mostly latent with rare pain syndromes. This period can last up to 10-15 years.
2. The second phase is characterized by more pronounced dysfunction of the digestive system. Inflammation causes an uncontrolled release of insulin into the blood, which can even lead to temporary hypoglycemia. The general condition is complicated by stool disorders, nausea, decreased appetite, gas formation in all parts of the gastrointestinal tract.
3. Pancreatic functionality is critically reduced. If on an empty stomach, the tests do not reveal any deviations, the glucose in the blood plasma is determined far beyond the normal time interval after the meal.
4. And in the last stage, secondary diabetes develops, which affects one-third of patients with chronic pancreatitis.

Characteristics of diabetes progression in chronic pancreatitis.

It would be logical to conclude that two diseases are much more difficult to treat than one. But practice shows the failure of such a conclusion. The secondary procedure has several features, thanks to which it can be well cured:

• It passes almost without ketoacidosis;
• Insulin treatment often results in hypoglycemia;
• It tolerates a low-carbohydrate diet well;
• In the first stage, oral medications for diabetes are quite effective ..

Prevention and treatment of pancreatic diabetes

Not every chronic pancreatitis necessarily causes the development of diabetes. With proper treatment and a strict diet, you can not only improve your pancreas but also prevent the onset of diabetes.

The endocrinologist selects the individual treatment in each individual case. Depending on the indicators of the production of digestive enzymes through the gland, the competent specialist prescribes replacement therapy based on enzyme drugs of similar action. As well as insulin injections if needed.

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Diet for pancreatitis and diabetes

You need to know that proper treatment and strict adherence to diet can lead to a complete cure of these severe ailments. Eat often and in small meals - 250-300 grams in one meal. Give preference to products that contain protein: soy, eggs, meat, fish, nuts.

The danger of complications of diabetes

Remove from the diet acidic foods that cause rapid secretion of gastric juice: sour, spicy, smoked, fried, containing alcohol, too hot or cold. In a word, all dishes. which can cause additional stress on pancreatic secretion.

Food should be steamed and consumed hot, not hot or cold.

If it is difficult to choose the right diet on your own, you can apply specially designed dietary recommendations collected under the names: table no. 5 for patients with pancreatitis and table no. 9 for diabetics. But before choosing this or that diet, it is necessary to consult a doctor.

Only taking into account all the features of the course of the disease and the general condition of the patient, the doctor gives the most accurate dietary recommendations.

Product selection

In different periods of the disease, the diet may vary slightly. Thus, for example, sweet and sour fruits or dishes based on rice, oatmeal and porridge are quite acceptable during a period of prolonged remission, completely excluded when the disease worsens.

Suitable products should be selected individually for each patient, taking into account:

1. Personal preferences;
2. Ability to observe glucose;
3. Intolerance to any substance;
4. Correction of partial absorption of nutrients.

In the acute period, it is strictly forbidden to eat foods high in sugar, fatty and smoked foods, pastries, fried foods, cereals: rice, oatmeal, porridge; raw fruits and vegetables, white bread.

A proper wellness diet always includes protein products, lean beef, chicken breast, low-fat fish, buckwheat porridge, gray dry bread, crackers, dryers, steamed vegetables, and fruits or a stew with a minimum amount of fat.

As for vegetable oils, it is better to use, in reasonable quantities, flaxseed and olive first cold-pressed, which have medicinal properties. It will also damage low-fat milk. Milk enriches the body with vitamins, minerals and helps alleviate inflammatory processes in the digestive tract.

Unfortunately, people are so arranged that understanding the full value of health, they still “dig with a rough spoon”. But the same folk wisdom has long since found a simple solution to the problem of the pancreas - hunger, cold, and peace.

By adhering to this simple rule and following a specially selected therapy, most patients can overcome many ailments and return to a healthy and complete state.

Pancreatin for type 2 diabetes mellitus

However, this mechanism is not a regularity. Many patients who already suffer from type 1 or type 2 diabetes develop pancreatitis. And people who have been diagnosed with chronic pancreatitis can avoid this complication.

Pancreas and diabetes

Pancreatin - a digestive enzyme designed to compensate for the lack of function of the exocrine organs of the pancreas.

The main active ingredient is pancreatin, which includes enzymes - lipase, proteinase, amylase. Due to these components, proteins, triglycerides, and starch are broken down.

According to the instructions for the drug, the drug is indicated for chronic pancreatitis, which allows taking Pancreatinum in diabetes complicated by this disease ..

Rationale for use

Diabetes and chronic pancreatitis are interrelated.

With the loss of exocrine function of the pancreas, there is exocrine insufficiency (production of enzymes is reduced), which can cause a complication - pancreatogenic diabetes mellitus.

The chronic inflammatory process in pancreatitis leads not only to exocrine insufficiency but also to the destruction of the islets of Langerhans. Exocrine pancreatic failure is particularly common in type 2 diabetes.

Pancreatogenic diabetes is characterized by the following symptoms:

• dyspeptic symptoms;
• epigastric pain;
• increased blood glucose;
• skin diseases;
• frequent infections.

The combination of diabetes and chronic pancreatitis requires a special approach to treatment tactics.

Methods of treatment

Due to the fact that the development of diabetes depends on the presence of chronic pancreatitis in the patient, the treatment of the disease is to eliminate the main cause - pancreatitis.

The basis of therapy is a strict diet and diet. Drug treatment is complex and involves the use of enzyme preparations. It is recommended to take pancreatin for type 2 diabetes.

Treatment of pancreatogenic diabetes requires compensation of exocrine pancreatic insufficiency, which can be achieved by using pancreatin or its analogs: Festal, Mezim, Creon.

Effect of pancreatin on diabetes

The naming of enzymes in diabetes contributes to:

• improve carbohydrate metabolism;
• stabilization of glycated hemoglobin;
• increased glycemic control;
• reduce the risk of complications of diabetes;
• improving the quality of life of patients and improving their well-being.

According to research by German scientists, pancreatin therapy for exocrine pancreatic insufficiency in type 2 diabetes can be used in conjunction with hypoglycemic agents and does not affect the patient’s glycemic profile. Such treatment is considered very effective and safe.

Use

In diabetes, pancreatin should be taken in strict accordance with the recommendations of the official instructions for the drug ..

The single daily dose is determined in terms of lipase, according to the age of the patient and the complexity of the disease.

The average daily lipase requirement for an adult patient is 150,000 units. In case of complete pancreatic insufficiency - 400 thousand units.

It is recommended to take pancreatin tablets after a meal, 3 times a day. The duration of therapy is determined by the doctor and can range from a few days to several months or years.

Concomitant use of drugs with iron-containing preparations may reduce iron absorption.

MEZIM, FESTAL, PANCREATIN, ENZIBENE can cause a complication of diabetes. - Treatment by the method of Dr. Skachko Boris

Skachko Boris

Mezim, festal, pancreatin, enzymes in diabetes mellitus cause complications!

The pancreas is involved in the digestion of all major sources of energy (proteins, fats and carbohydrates). This ensures the complete assimilation of digestive products in the cells. It is important to maintain a balance of both components.

The balance should also be observed from the side of the exocrine function of the pancreas, whose enzymes (proteases, lipases, and aldolases) ensure the digestion of food in the gastrointestinal tract. This is also the case with the endocrine function of the pancreas, which provides a reduction in blood sugar through the hormone insulin. And regulation of other types of metabolism of energy substrates (proteins, fats).

What happens to type 1 or type 2 diabetes? Impaired glucose uptake into cells occurs when insulin is insufficiently produced in the pancreas (type 1 diabetes mellitus) or when the pancreas produces defective insulin, impaired insulin receptor sensitivity, and liver resistance to insulin (type 2 diabetes). This is a standard situation with high blood sugar.

How can mesime, festal, pancreatin, enzymes, and other enzyme preparations affect this situation? Very simple. The intake of additional digestive enzymes into the body not only speeds up but also speeds up the digestive process.

This causes an imbalance in the activity of the exocrine and endocrine pancreas. And a rapid rise in blood sugar and stress on the pancreas. Which worsens diabetes mellitus, both type 1 and type 2. Because.

requires either more sugar-lowering drugs, in the case of type 2 diabetes. Or the introduction of additional units of insulin in type 1 diabetes.

What will you get if you do not take the enzyme preparation if you have diabetes? Activation of intestinal microflora, decay process (protein food), or fermentation (carbohydrate food). Absorption of toxic substances into the blood, overloading the possibilities of detoxification function of the liver and kidneys. In general, good is not enough. Especially if there is type 1 diabetes.

What happens when enzyme preparations (pancreatin, mezim, festal, enzyme) are taken by people who do not have diabetes? On the one hand, improving the digestive process reduces bloating and swelling. On the other hand, replacement therapy leads to a gradual decrease in the ability of the pancreas, its exocrine function.

And it translates a person into a constant use of enzyme preparations. And the increase in the absorption of digestive products into the blood overloads the endocrine function of the pancreas, and in the future there will be type 2 diabetes.

A sharp increase in blood viscosity can lead to more serious consequences - increased heart risk, risk of developing a hypertensive crisis, myocardial infarction, stroke.

What is pancreatogenic diabetes mellitus, its diagnosis, and treatment

Pancreatogenic diabetes mellitus occurs most often after pancreatitis, but it can also be caused by trauma, surgery, and a pancreatic tumor.

The mechanism of development is related to the destruction of cells that produce insulin and other hormones. The course is often hidden, does not manifest symptoms for a long time.

Features: causes alcoholism, patients are not obese, there is a tendency to drop sugar (hypoglycemic conditions).

Detection requires a glucose tolerance test (sugar load), a percentage of sugar at speed, and high postprandial rates. Treatment includes diet, use of enzymes (Festal, Mezim), sugar reduction pills.

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What is pancreatogenic diabetes mellitus?

Pancreatogenic diabetes mellitus is an increase in blood sugar in the presence of pancreatitis (inflammation of the pancreas). Such diabetes is called secondary and differs from type 1 and type 2 in its course ..

It is found in 10-90% of cases of a chronic inflammatory process because the link between pancreatitis and diabetes is not always found in a timely manner. It usually affects men who are prone to consuming alcohol and fatty foods. Specific pancreatogenic diabetes mellitus in 15% of cases complicates acute inflammation of the pancreas.

Common causes of pancreatitis and diabetes

The development of pancreatitis and diabetes is caused by:

• alcohol intake (systemic abuse);
• a diet with excess fatty and sweet foods, lack of vegetables, fruits, vegetable fats, and dietary fiber;
• overeating, lack of meal regime;
• hormone administration (prednisone and analogs).

Pancreatogenic diabetes mellitus is also possible during surgery due to pancreatitis, cancer, pancreatic necrosis (partial tissue necrosis), abdominal trauma.

How pancreatitis and diabetes are related

Acute and long-term chronic pancreatitis leads to diabetes which is explained:

• destruction of pancreatic tissue;
• reduction in the number of cells that produce insulin, glucagon and pancreatic protein (polypeptide);
• violation of food digestion;
• worsening of intestinal incretin production (hormones that stimulate the release of insulin in response to food intake).

Therefore, diabetes mellitus on the background of pancreatitis appears on the background of insulin deficiency. Hormone deficiency interferes with the absorption of carbohydrates, blood sugar rises after meals and does not decrease enough.

Digestion, there is a lack of many hormones that regulate digestion, diabetes after pancreatitis. Patients have frequent changes in blood glucose.

Classification

Pancreatogenic diabetes mellitus is once included in the classification called type 3c diabetes, it occurs according to the mechanism of development:

• fibrocalculous - on the background of chronic inflammation, areas of compression, scar growth, and calcification (deposits of calcium salts) are formed;
• protein deficiency - occurs on the background of protein deficiency.

Depending on the causes of pancreatitis itself, diabetes can be the result of alcohol intoxication or liver disease, biliary tract (biliary). In the first case, a serious violation of carbohydrate metabolism was recorded.

How do pancreatitis manifest itself in type 1 and 2 diabetes?

In type 1 and 2 diabetes, acute pancreatitis occurs with severe symptoms:

• pain in the epigastric region, in the left hypochondrium, is shingles, gives under the left shoulder blade;
• the attack of pain does not die, and its intensity only increases, it becomes worse when you lie on your back;
• spicy and fatty foods, fried foods, alcohol worsen;
• vomiting relentlessly does not give relief;
• increase in body temperature;
• fever;
• yellowing of the sclera of the eyes, less often of the skin;
• bloating, heartburn.

In chronic pancreatitis, the symptoms periodically decrease, characterized by alternating diarrhea and constipation, weight loss, aversion to food. As pancreatitis progresses, exacerbations become more frequent, and periods of remission (pain ceases) shorten.

Course features

Diabetes mellitus during development after pancreatitis has the following features:

• it usually occurs in adulthood in patients of thin or normal build (type 1 occurs in children and adolescents, and 2 in obese);
• there are always pronounced symptoms of indigestion - bloating, bloating, nausea, heartburn;
• there is a pain in the upper abdomen, worsening to worsening;
• the moderate increase in blood glucose;
• sugar often falls, and there is no increase typical of diabetes (hyperglycemic and ketoacidosis condition);
• with sugar, up to 10 mmol / l, there are no symptoms, but only with greater thirst, dry mouth and skin, excessive urine output.

Patient diagnosis

It is quite difficult to identify the disease because the signs of diabetes are often erased. For diagnosis, all patients with pancreatitis should consult an endocrinologist, he first determines additional risk factors:

• previous surgeries, abdominal injuries;
• alcohol consumption;
• use of hormonal drugs.

Laboratory examination includes:

• general blood test;
• glucose tolerance test: usually empty stomach sugar is normal or slightly elevated and shows a high rate after sugar loading;
• blood biochemistry with the determination of pancreatic enzyme activity (amylase, lipase, trypsin);
• urine analysis (glucose and ketone bodies, usually not).

Instrumental diagnostic methods:

• Ultrasound of the abdominal cavity;
• tomography of the pancreas.

These methods of studying the structure help to find places with heterogeneous tissue, seals, calcifications.

If an endocrinologist suspects that diabetes is a classic type 1 option, he or she prescribes a blood test for antibodies to pancreatic cells, C-peptide, and insulin.

Type 2 is characterized by obesity, tissue resistance to insulin and attacks of sugar drop are extremely rare.

Diet for diabetes and pancreatitis: principles of nutrition

The basic rules of creating a diet for diabetes and pancreatitis are similar in dietary principles and prohibitions on foods containing sugar, alcohol and fatty foods. It is also recommended:

• introduction into the diet of vegetables, cereals;
• use of lean fish and meat varieties;
• Cooking in the form of boiling, baking, cannot be fried and sautéed with oil;
• the menu should contain dairy products without acids and non-fatty acids - yogurt, fermented milk, cheese;
• frequent and fractional meals;

in case of deterioration, it is necessary to limit animal fats as much as possible and grind food (puree and cereal soups, the meat is drilled twice through a meat grinder).

Prohibited products

For diabetes, the list of forbidden foods includes:

• alcoholic and carbonated beverages, kvass;
• lamb, pork, salad, fatty and spicy cheese;
• heavy cream and sour cream, butter;
• Navara: meat, fish, mushrooms;
• semi-finished products;
• canned foods, marinades, pickles, smoked meats;
• sausage;
• chocolate;
• ice cream;
• sweets;
• muffin, puff pastry;
• fast food, chips, crackers with salt and spices;
• condensed milk;
• mayonnaise, ketchup, vinegar, horseradish, mustard, pepper;
• radish, spinach, onion, garlic;
• millet, pearl barley;
• sour fruits and berries.
• Permitted products
• What can be included in the diet:
• vegetarian soups;
• meat: beef, veal, chicken, turkey, rabbit;
• fish: pike, pollock, cod, pike, perch;
• cheese of 2-5% fat, 1.5-2% yogurt, fermented baked milk, yogurt, 10% sour cream;
• vegetables: zucchini, pumpkin, cauliflower, broccoli, green beans, young green peas;
• steamed egg eggs;
• cereals: buckwheat, oatmeal, rice, hard flour pasta;
• baked apples, plums and apricots to add to compote, spoons;
• dried gray bread;
• compote, sour, weak tea, mint and chamomile;
• stevia or fructose is added instead of sugar.

Example menu for pancreatitis and diabetes

With the worsening of pancreatitis and diabetes, the menu may be as follows:

• breakfast: oatmeal porridge, baked apple without peel, weak tea;
• lunch: steamed protein omelet;
• lunch: zucchini soup, cauliflower, carrots, chicken breast cutlets (steam), viscous buckwheat;
• snack: cheese souffle, yogurt;
• dinner: boiled fish with boiled potatoes, compote;
• before going to bed: fermented baked milk.

Without deterioration, the diet can be expanded:

• breakfast: rice porridge with pumpkin, chicory with milk;
• lunch: dried or yesterday’s bread with Adyghe cheese, tea;
• lunch: vegetable soup with fish meatballs, roasted turkey with carrots and herbs, stewed fruit;
• afternoon snack: cottage cheese with baked apple, kissel;
• dinner: boiled chicken with buckwheat porridge, boiled cabbage with herbs, weak tea;
• before going to bed: kefir, fructose cookies.

Treatment of diabetes pancreatitis

The most important condition in the treatment of diabetes and pancreatitis is the simultaneous treatment of two diseases. To do this, you must:

• consistently adhere to a diet, not just with deterioration;
• quit smoking and drinking alcohol;
• take drugs with enzymes for replacement therapy (Creon, Festal);
• use sugar-lowering tablets with mandatory daily monitoring of blood sugar levels (Siofor, Glucofage), do not lower it below 4.5 mmol / l.

If pancreatitis is performed (partial or complete removal of the tail), then the patient with diabetes must be switched to insulin. Injections are given in small doses before meals. After stabilizing the sugar level, it is possible to prescribe tablets continuously.

In extremely severe pancreatitis, surgery to transplant your own insulin-producing islet cells may be needed. After that, the pancreas is removed. This method of treatment is available only in large specialized endocrinology centers ..

Possible complications without treatment for worsening pancreatitis in diabetes

If the patient does not adhere to treatment and neglects diet, smokes, drinks alcohol, then frequent exacerbations of pancreatitis and worsening of the course of diabetes are inevitable. Vascular complications arise from:

• kidneys - diabetic nephropathy;
• retina - retinopathy;
• blood flow - angiopathy;
• nervous system: peripheral (limb) in the form of neuropathy, brain - encephalopathy.

Due to the violation of food digestion, vitamins and minerals are not absorbed properly, so vascular lesions become more difficult. Sharp fluctuations in blood sugar are characteristic of patients with type 3 diabetes.

Attacks of hypoglycemia are caused by a feeling of hunger, sweating, general restlessness, trembling hands, the skin becomes pale and covered with cold sweat.

If you do not take sweet tea or a spoonful of honey at this time, then there is a loss of consciousness with convulsions, coma is possible.

Prognosis and prevention

If you diagnose diabetes with pancreatitis in a timely manner and follow the therapy recommendations exactly, then the prognosis for a pancreatogenic rise in blood sugar is good.

It is possible to normalize the digestion and metabolism of carbohydrates. The prognosis for tumors and extensive pancreatic surgery is even worse.

Factors that complicate treatment include alcoholism, smoking, neglect of diet ..

To prevent type 3c diabetes, it is important to consult a doctor for symptoms of pancreatitis and undergo a comprehensive examination by an endocrinologist. At least once a year (even with the usual tests and well-being) preventive courses of drugs to improve the pancreas are taken. The diet is prescribed on a permanent basis.

Pancreatogenic diabetes mellitus occurs due to inflammation of the pancreas, leading to sharp fluctuations in blood sugar. Be sure to follow a diet, use enzymes and tablets to lower sugar, refuse alcohol.

Diabetic pancreatitis: everything you need to know

Chronic pancreatitis is an inflammatory phenomenon that develops in the pancreas, which leads to irreversible transformations in cells and tissues. In the case of a severe course of the disease, a significant portion of the pancreatic tissue is replaced. 

In this case, the glandular tissue degenerates into connective and adipose tissue. Internal and external secretion is disturbed in the body. At the level of external secretory deficiency, the development of enzyme deficiency occurs, and at the level within the secretory deficiency, glucose tolerance and, as a consequence, diabetes mellitus.

 This type is called pancreatogenic, that is, formed on the background of inflammation of the pancreas. It is chronic pancreatitis that causes diabetes mellitus (DM). Undoubtedly, diabetes can occur as an independent disease, so patients with type 1 or type 2 diabetes may develop classic pancreatitis.

Pancreatitis and diabetes: developmental mechanism

Scientists have not yet reached a unanimous opinion on the details of pathogenesis. But it is not news that the gradual destruction and sclerosis of the islet apparatus lead to diabetes as a reaction to inflammatory phenomena in neighboring cells that produce digestive enzymes.

The pancreas has the property of mixed secretion. Its first function is the production of enzymes and the release of their digestive tract to digest food, the second function is the production of insulin - a hormone whose regulation regulates glucose levels. The prolonged course of pancreatitis may be jeopardized by the fact that in addition to the pancreas, which is responsible for digestion (enzyme apparatus), it will affect the islet zone, which is in the form of the islet of Langerhans ..

Other endocrine diseases often act as triggers. Clinically, secondary diabetes mellitus is similar to type 1 diabetes but differs in the lack of autoantibody gland tissue damage.

• Itsenko-Cushing's disease stimulates the release of hormones from the adrenal cortex. Excess cortisol reduces glucose uptake into tissues, which increases its level in the blood.
• Pheochromocytoma - a tumor with hormonal activity. The tumor can randomly throw high doses of catecholamines into the bloodstream, which, as mentioned, increases blood sugar. With acromegaly, high levels of growth hormone have an insulin-like effect. This is accompanied by the fact that the production of insulin by the pancreas and betta is weakened - the cells gradually atrophy.
• Glucagonoma produces the counter-hormone glucagon. With increased secretion, there is an imbalance of the endocrine system responsible for carbohydrate metabolism, and diabetes reappears.
• Hemochromatosis contributes to the increased accumulation of iron in the pancreas, which leads to its damage, including damage to beta cells.
• Wilson-Konovalov disease is accompanied by excessive accumulation of copper in the liver, which violates the deposition of glucose in it and, as a result, leads to diabetes.

Cohn's syndrome is associated with a disorder of potassium metabolism. Liver hepatocytes cannot do without the help of a potassium pump, using glucose. Symptomatic hyperglycemia also occurs in this case.

In addition to endocrine diseases, which in one way or another increase glucose, pancreatic lesions are also possible. These include complications of post-pancreatectomy, pancreatic cancer, and somatostatinoma. The pancreas, in addition, can be a target when dangerous toxins (pesticides, glucocorticosteroids) are exposed to the body. The development of hyperglycemia and diabetes takes place in a similar way.

Pancreatogenic diabetes: causes and symptoms

The leading link in the pathogenesis of pancreatogenic diabetes is progressive sclerosis and destruction of the islet apparatus (not every betta cell, but a certain percentage of them). Some scientists do not rule out autoimmune causes of the disease.

Pancreatogenic diabetes develops, which is different from type 1 or type 2 diabetes:

• With insulin therapy, hypoglycemic episodes are more common.
• Insulin deficiency causes more frequent cases of ketoacidosis.
• Pancreatogenic diabetes is easier to correct with a low-carb diet.
• More effective in treating diabetes pills.

Class 2 diabetes mellitus develops on the background of complete or partial insular insufficiency. Insulin deficiency develops as a result of insulin resistance, which in turn appears as a hypercaloric diet with a predominance of low molecular weight carbohydrates. Unlike type 2 diabetes, pancreatogenic diabetes develops as a result of direct damage to beta cells by enzymes.

Pancreatitis in diabetes mellitus (the second disease developed independently, and the first is the background) looks different: inflammation of the pancreas is chronic, there are no exacerbations, the sluggish type of course prevails.

The highest risk group is people who suffer from alcoholism. More than 50% of patients begin to develop pancreatitis of alcoholic origin. The risk includes gastroduodenal ulcers, people prone to protein deficiency.

The disease is accompanied by three main phenomena: diabetes, pain, and impaired digestive function. Clinically and pathogenetically, the disease can be described as follows:

• First, there is a change in the process of exacerbation and remission of the disease. In this case, the pain occurs with the pain of varying intensity or localization. The period lasts 10 years.
• Dyspeptic phenomena come to the fore: diarrhea, heartburn, decreased appetite, and bloating. Hypoglycemic episodes soon join (carbohydrate metabolism is disturbed). Hypoglycemia occurs due to an increase in insulin levels in the blood due to the stimulation of beta cells by aggressive pancreatic enzymes.
• During a diffuse lesion of the pancreas, cells and tissues continue to break down, and impaired glucose tolerance is soon formed. Then the sugar on the voice is within normal limits, but after a meal or the glucose tolerance test is higher than normal.
• When hyperglycemia increases and decompensation of carbohydrate metabolism reaches a peak, diabetes develops. Diabetes debuts in 30 patients with long-term chronic pancreatitis, which is 2 times more likely than diabetes due to other causes.

Herbal diet for pancreatitis and diabetes

Despite the wide variety of antidiabetic drugs and drugs to treat pancreatitis, diet therapy is the basis for the treatment of diabetes, especially in combination with pancreatitis. A unique diet is shown for each of the diseases, so the diet for pancreatitis and diabetes is particularly strict. It is strictly forbidden to eat fried, spicy, fatty foods, alcohol. The following products are not recommended: meat soups, apples, cabbage. Protein foods should not exceed 200 grams per day.

Raw vegetables and fruits are in principle the basis of any person’s diet, as the genome of a rational person has been adapted to foods of plant origin over many millions of years of evolution. Proteins of animal origin will stimulate the production of aggressive digestive enzymes of the patient, which will inadequately affect the already damaged gland and the course of the disease. Therefore, plant foods are recommended for diabetics and patients with pancreatitis if:

1. There is no worsening of pancreatitis.
2. These are not the first two years of pancreatitis.
3. Fruits of soft consistency.
4. Peeling removed (coarse fibers cause bloating).
5. We consume fruits and vegetables in small meals.

Diabetes mellitus does not develop in all patients with pancreatitis. Damage to the pancreas leads to diabetes in 30% of cases. Pancreatitis and diabetes "hold" because one and the same organ is affected - the pancreas.

Whether these diseases occur independently or are interdependent, therapy requires a careful approach. Enzyme preparations for the treatment of digestive dysfunction of the gland are prescribed here, and antidiabetic drugs for the treatment of the underlying disease (insulin, tablets).