The prevalence of diabetes in children and adolescents is increasing worldwide, with profound implications on the longterm health of individuals, societies, and nations. Presence of autoimmunity to pancreatic antigens in a. It is associated with an increased risk of pancreatic carcinoma. Fibrocalculous pancreatic diabetes fcpd springerlink. Fibrocalculous pancreatic diabetes fcpd is a form of diabetes secondary to chronic pancreatitis that is found in tropical countries. Assessment of insulin sensitivity and secretion in. Fibrocalculous pancreatic diabetes and obesity mayo clinic. Fibrocalculous pancreatic diabetes in a young ugandan. Fibrocalculous pancreatic diabetes is a unique entity wherein pancreatic calcification and chronic inflammation lead to exocrine and endocrine failure of the pancreas. Pdf spink1 is a susceptibility gene for fibrocalculous. 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. These recommendations, and the current definitions of diabetes mellitus and.
It has been widely described exclusively in developing tropical countries. 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. Fibrocalculous pancreatic diabetes is an infrequent type of secondary diabetes due to chronic tropical non alcoholic calcific pancreatitis. Diabetes mellitus represents a set of autoimmune, metabolic and genetic disorders that share one major characteristic hyperglycaemia. Volume 12 original research assessment of insulin sensitivity and secretion in patients with fibrocalculous pancreatic diabetes. While majority of patients have onset\ud of diabetes in youth childhood onset fcpd is less\ud common. Pancreatitis in fibrocalculous pancreatic diabetes mellitus is not associated with common mutations in the trypsinogen gene. 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. Fibrocalcific pancreatic diabetes fcpd is a rare form of diabetes affecting people in the tropics and presenting with unique clinical and radiological features. Chittaranjan s yajnik, sudha v kanitkar, kishore m shelgikar, sadanand s naik, k george m m alberti, derek hockaday. Pancreatic cpeptide response to oral glucose in fibrocalculous pancreatic diabetes.
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. 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. Secular trends of fibrocalculous pancreatic diabetes and. Fibrocalculus pancreatic diabetes fcpd is a rare form of diabetes. Fibrocalculous pancreatic diabetescurrent scenario in developing. Insulin deficiency plays a major role in the etiopathogenesis of fcpd. Fibrocalculous pancreatic diabetes by v mohan and g premalatha download pdf 150 kb. Tropical chronic pancreatitis postgraduate medical journal. The diagnosis and management of diabetes in youth presents several unique challenges. The patients generally have clinical triad of pain abdomen, steatorrhoea and diabetes. A diagnosis is made basing on the presence of abdominal pain, presence of pancreatic calcifications, steatorrhoea, and diabetes mellitus. Fibrocalculous pancreatic diabetes is an uncommon form of diabetes secondary to chronic nonalcoholic calcific pancreatitis found in tropical parts of the globe. Limited data suggest a possible role of insulin resistance ir in the pathogenesis of fcpd.
Fibrocalculous pancreatic diabetes and macrovascular. Pdf prevalence of fibrocalculous pancreatic diabetes in. 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. Exocrine pancreatic function in tropical fibrocalculous. Challenges in diagnosis and management of diabetes in the. These findings provide evidence for autoimmunity to pancreatic antigens in a patient with fibrocalculous pancreatic diabetes. The association of malnutrition and diabetes was first documented by.
Research design and methods details of presenting symptoms, anthropometry, diabetic tissue damage, treatment, and. 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 and macrovascular disease article in the journal of the association of physicians of india 49. 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. Fibrocalculous pancreatic diabetes fcpd is seen mainly in young and malnourished individuals belonging to tropical and developing countries. Fibrocalculous pancreatic diabetes in a young female journal of. 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. Bernhard radlinger, gabriele ramoser, susanne kaser article. Download pdf 464kb view article obesity km gadde, section editor. Hassan z, mohan v, ali l et al, spink1 is a susceptibility gene for fibrocalculous. 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.
Fibrocalculous pancreatitis diabetes fcpd, a secondary form of. 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. 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. This paper reports on two unusual cases of fcpd with age of onset below 5 years. Objective to determine the longterm survival and causes of death in fibrocalculous pancreatic diabetes, a form of diabetes secondary to tropical chronic pancreatitis. Prevalence of fibrocalculous pancreatic diabetes in. Fibrocalculous pancreatic diabetes fcpd is a form of diabetes secondary to tropical calcific pancreatitis usually affecting the poorer strata of society. Context fibrocalculous pancreatic diabetes is a form of diabetes secondary to chronic pancreatitis found in tropical, developing countries. The disease is restricted to tropical regions of the world, and southern india has the highest known prevalence of fcpd. Histopathology and immunohistochemistry of pancreatic.
Exocrine pancreatic insufficiency, as shown by low fecal chymotrypsin levels, was seen in 87. Fcpd is one of the two forms of malnutrition related diabetes mellitus. Fibrocalculous pancreatic diabetes in a patient from bihar by s vidhya, g premalatha, v mohan and j s ravikumar download pdf 780 kb. Four patients with fcpd who were obese are reported in this paper and.
Fibrocalculous pancreatic diabetes and obesity sciencedirect. About 80% of patients were alive 35 years after the first episode of abdominal pain. The usual age of onset of fcpd is between 15 and 50 years. The typical patient with fcpd is a lean adolescent or young adult of either sex, presenting with history of. Context data on prevalence and trends in diabetes secondary to chronic pancreatitis in developing countries is scarce. Fibrocalculous pancreatic diabetes mellitus fcdp is a unique form of. 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. Other forms of diabetes and its complications jj nolan and h thabit, section editors. He was diagnosed to have diabetes mellitus since 2 years.
The median survival time after the diagnosis of diabetes was 25 years. 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. Rozario papita, adamsha nazir, viknesh prabu anbalagan, ranjit mohan anjana, capecomorin pitchumoni, suresh chari, viswanathan mohan. There is no population based data on prevalence of fibrocalculous pancreatic diabetes. Although type 1 diabetes is more common among children and adolescents, the incidence of type 2 diabetes in youth is also on the rise.
Diabetes mellitus, chronic pancreatitis, fibrocalculous. Moreover, druginduced diabetes and genetic forms of diabetes would spread out heterogeneously among the different clusters. Pdf fibrocalculous pancreatic diabetes is a form of diabetes secondary to chronic pancreatitis found in. Pdf pancreatitis in fibrocalculous pancreatic diabetes. Tropical chronic pancreatitis tcp is a juvenile form of chronic calcific nonalcoholic pancreatitis, seen almost exclusively in the developing countries of the tropical world. Therefore a high index of suspicion is necessary in early diagnosis and treatment. Fibrocalculous pancreatic diabetes fcpd is a form of diabetes secondary to tropical calcific pancreatitis tcp. Spink1psti mutations are associated with tropical pancreatitis. Fibrocalculous pancreatic diabetes fcpd is a secondary form of diabetes seen in patients with tropical chronic pancreatitis. Emerging concepts in the pathogenesis of diabetes in.
Prevalence of fibrocalculous pancreatic diabetes in chennai in south india article pdf available in jop. Fibrocalculous pancreatic diabetes in infancy two case. Four patients with fcpd who were obese are reported in this paper and this is the first report of obesity in fcpd patients. When diabetes is present, the condition is called fibrocalculous pancreatic diabetes fcpd which is thus a later stage of tcp. Fibrocalculous pancreatic diabetes fcpd remedy publications. Fibrocalculous pancreatic diabetes fcpd is a\ud form of diabetes secondary to tropical chronic\ud pancreatitis. The association of malnutrition and diabetes was first documented by zuidema in 1959 from indonesia. Secular trends of fibrocalculous pancreatic diabetes and diabetes secondary to alcoholic chronic pancreatitis at a tertiary care diabetes centre in south india. 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 diabetes secondary to chronic calcific pancreatitis. The classical triad of tcp consists of abdominal pain, steatorrhoea, and diabetes.
Results longterm survival of patients with fibrocalculous pancreatic diabetes is much better today than that described 30 years ago. Fibrocalculus pancreatic diabetes in a young female. Pdf prevalence of fibrocalculous pancreatic diabetes in chennai. 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. The onset of diabetes usually follows the first few episodes of abdominal pain and develops by the second or third decade of life. He had a history of missing insulin doses frequently for extended periods and was. 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. Current diabetes reports, volume 20, issue 6 springer. Most patients with fcpd are lean and many are frankly undernourished.
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