Pancreatic insufficiency – colloquially called pancreatic weakness – (synonyms: pancreatic insufficiency; pancreatic function, inadequate; ICD-10 E16. 9: disorder of internal secretion of the pancreas, unspecified) refers to the inability of the pancreas to produce sufficient digestive enzymes (= exocrine pancreatic insufficiency, EPI) and, in later stages, hormones such as insulin (= endocrine pancreatic insufficiency). It usually occurs as a complication of chronic pancreatitis (inflammation of the pancreas), pancreatic carcinoma (pancreatic cancer) or cystic fibrosis (cystic fibrosis).
Symptoms of pancreatic insufficiency develop quite late. Usually, more than 90% of the pancreas has already perished.
Sex ratio: Men are affected almost twice as often as women.
Frequency peak: The disease occurs predominantly between the 45th and 54th year of life.
The prevalence (disease incidence) for exocrine pancreatic insufficiency (EPI) is increased in patients with type 1 or 2 diabetes mellitus. In type 1 diabetes, the prevalence ranges from 26 to 57% and in type 2 diabetics, one in three suffers from EPI (in Germany).
The incidence (frequency of new cases) is about 3-4 cases per 1,000 hospital admissions per year (in Europe).
Course and prognosis: Pancreatic insufficiency is not reversible, i.e. it cannot be cured. Due to insufficient production of digestive enzymes, exocrine pancreatic insufficiency, if left untreated, leads to marked digestive disturbances with weight loss or lack of weight gain (especially in children). Therefore, pancreatic digestive enzymes must be supplied as medication with meals. The diet must be adjusted accordingly (abstinence from alcohol, high carbohydrate, low fat, many small meals/day; substitution of fat-soluble vitamins A, D, E and K if necessary). In endocrine pancreatic insufficiency, insulin-dependent diabetes mellitus develops, so insulin therapy is required.
