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The endocrine and exocrine portions of the pancreas are central regulators in digestion and metabolism, with continuous crosstalk between their deeply interconnected components, which plays a role in disease. Pancreatic neoplasms, inflammation, trauma, and surgery can lead to the development of type 3c diabetes when an insult simultaneously damages both acini and islets, leading to exocrine and endocrine dysfunction. In diabetes mellitus patients, pancreatic exocrine insufficiency is highly prevalent, yet little is known about the associations between diabetes mellitus and pancreatic exocrine function. 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Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Janah, L., Kjeldsen, S., Galsgaard, K.D., Winther-S\u00f8rensen, M., Stojanovska, E., Pedersen, J., Knop, F.K., Holst, J.J., and Albrechtsen, N.J.W. (2019). Glucagon Receptor Signaling and Glucagon Resistance. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20133314"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/MPA.0b013e318161b99a","article-title":"Negative control of human pancreatic secretion: Physiological mechanisms and factors","volume":"37","author":"Morisset","year":"2008","journal-title":"Pancreas"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1159\/000064718","article-title":"Are islet cells the gatekeepers of the pancreas?","volume":"2","author":"Pour","year":"2002","journal-title":"Pancreatol. Off. J. Int. Assoc. Pancreatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1679\/aohc.55.381","article-title":"The blood vascular bed of the human pancreas, with special reference to the insulo-acinar portal system. Scanning electron microscopy of corrosion casts","volume":"55","author":"Murakami","year":"1992","journal-title":"Arch. Histol. Cytol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/0192623313508851","article-title":"Mechanistic investigations of test article-induced pancreatic toxicity at the endocrine-exocrine interface in the rat","volume":"42","author":"Brenneman","year":"2014","journal-title":"Toxicol. Pathol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1093\/ije\/dyu240","article-title":"Risk factors for pancreatic cancer: A summary review of meta-analytical studies","volume":"44","author":"Maisonneuve","year":"2015","journal-title":"Int. J. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"425","DOI":"10.2165\/00003088-199936060-00004","article-title":"Drug interactions with tobacco smoking. An update","volume":"36","author":"Zevin","year":"1999","journal-title":"Clin. Pharmacokinet."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1080\/01926230390226041","article-title":"Differences in immunohistochemical expression of xenobiotic-metabolizing enzymes between normal pancreas, chronic pancreatitis and pancreatic cancer","volume":"31","author":"Standop","year":"2003","journal-title":"Toxicol. Pathol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.cmet.2006.01.004","article-title":"The biology of incretin hormones","volume":"3","author":"Drucker","year":"2006","journal-title":"Cell Metab."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"595649","DOI":"10.1155\/2015\/595649","article-title":"Exocrine pancreatic insufficiency in diabetic patients: Prevalence, mechanisms, and treatment","volume":"2015","author":"Piciucchi","year":"2015","journal-title":"Int. J. Endocrinol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"22297","DOI":"10.1074\/jbc.M500540200","article-title":"Glucose-dependent insulinotropic polypeptide (GIP) stimulation of pancreatic beta-cell survival is dependent upon phosphatidylinositol 3-kinase (PI3K)\/protein kinase B (PKB) signaling, inactivation of the forkhead transcription factor Foxo1, and down-regulation of bax expression","volume":"280","author":"Kim","year":"2005","journal-title":"J. Biol. Chem."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1053\/j.gastro.2007.03.054","article-title":"Biology of incretins: GLP-1 and, G.I.P","volume":"132","author":"Baggio","year":"2007","journal-title":"Gastroenterology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2845","DOI":"10.1016\/j.celrep.2016.11.051","article-title":"Glucagon-like Peptide 1 Receptor Signaling in Acinar Cells Causes Growth-Dependent Release of Pancreatic Enzymes","volume":"17","author":"Albrechtsen","year":"2016","journal-title":"Cell Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1093\/nutrit\/nuac056","article-title":"Effects of whole grain intake on glucagon-like peptide 1 and glucose-dependent insulinotropic peptide: A systematic review and meta-analysis","volume":"81","author":"Ghobadi","year":"2023","journal-title":"Nutr. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"E324","DOI":"10.1152\/ajpendo.00059.2006","article-title":"Increased postprandial responses of GLP-1 and GIP in patients with chronic pancreatitis and steatorrhea following pancreatic enzyme substitution","volume":"292","author":"Knop","year":"2007","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/j.1440-1746.2010.06600.x","article-title":"Pancreatic exocrine insufficiency: Diagnosis and treatment","volume":"26","year":"2011","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Vujasinovic, M., Valente, R., Del Chiaro, M., Permert, J., and L\u00f6hr, J.-M. (2017). Pancreatic Exocrine Insufficiency in Pancreatic Cancer. Nutrients, 9.","DOI":"10.3390\/nu9030183"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/j.pan.2018.09.003","article-title":"Diagnosis, treatment and long-term outcome of autoimmune pancreatitis in Sweden","volume":"18","author":"Vujasinovic","year":"2018","journal-title":"Pancreatology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"7258","DOI":"10.3748\/wjg.v19.i42.7258","article-title":"Diagnosis and treatment of pancreatic exocrine insufficiency","volume":"19","author":"Lindkvist","year":"2013","journal-title":"World J. Gastroenterol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"129","DOI":"10.2147\/CEG.S168266","article-title":"Exocrine pancreatic insufficiency: Prevalence, diagnosis, and management","volume":"12","author":"Capurso","year":"2019","journal-title":"Clin. Exp. Gastroenterol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1016\/j.soard.2021.06.019","article-title":"Exocrine pancreatic function and dynamic of digestion after restrictive and malabsorptive bariatric surgery: A prospective, cross-sectional, and comparative study","volume":"17","year":"2021","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1111\/apt.16949","article-title":"Systematic review-pancreatic involvement in inflammatory bowel disease","volume":"55","author":"Massironi","year":"2022","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_34","first-page":"17","article-title":"Pancreatic exocrine insufficiency and Crohn\u2019s disease","volume":"66","author":"Steiner","year":"2020","journal-title":"Minerva Gastroenterol. Dietol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/MPA.0000000000000721","article-title":"Pancreatic Insufficiency Secondary to Tobacco Exposure: A Controlled Cross-Sectional Evaluation","volume":"46","author":"Raphael","year":"2017","journal-title":"Pancreas"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1056\/NEJM197304192881603","article-title":"Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency","volume":"288","author":"DiMagno","year":"1973","journal-title":"N. Engl. J. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1016\/j.pan.2016.09.008","article-title":"Deficiency of fat-soluble vitamins in chronic pancreatitis: A systematic review and meta-analysis","volume":"16","author":"Stigliano","year":"2016","journal-title":"Pancreatology"},{"key":"ref_38","first-page":"78","article-title":"Pancreatic exocrine insufficiency in critically ill adult patients","volume":"58","author":"Ma","year":"2016","journal-title":"Panminerva Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1177\/1457496920905559","article-title":"Conservative Treatment of Chronic Pancreatitis: A Practical Approach","volume":"109","author":"Valente","year":"2020","journal-title":"Scand. J. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.pan.2012.11.307","article-title":"Fecal elastase-1 is useful in the detection of steatorrhea in patients with pancreatic diseases but not after pancreatic resection","volume":"13","author":"Benini","year":"2013","journal-title":"Pancreatology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/0016-5085(89)91632-6","article-title":"Mixed triglyceride breath test: A noninvasive test of pancreatic lipase activity in the duodenum","volume":"96","author":"Vantrappen","year":"1989","journal-title":"Gastroenterology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"7177","DOI":"10.3748\/wjg.v19.i41.7177","article-title":"Quantification of pancreatic exocrine function of chronic pancreatitis with secretin-enhanced MRCP","volume":"19","author":"Bian","year":"2013","journal-title":"World J. Gastroenterol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.pan.2018.09.016","article-title":"Recommendations from the United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis","volume":"18","author":"Drewes","year":"2018","journal-title":"Pancreatology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"3880","DOI":"10.2337\/db14-0549","article-title":"Increased immune cell infiltration of the exocrine pancreas: A possible contribution to the pathogenesis of type 1 diabetes","volume":"63","author":"Ekwall","year":"2014","journal-title":"Diabetes"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2030","DOI":"10.12968\/bjon.2000.9.18.12461","article-title":"Pancreatic exocrine insufficiency and type 1 diabetes mellitus","volume":"9","author":"Canaway","year":"2000","journal-title":"Br. J. Nurs."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1159\/000073655","article-title":"High prevalence of exocrine pancreatic insufficiency in diabetes mellitus. A multicenter study screening fecal elastase 1 concentrations in 1,021 diabetic patients","volume":"3","author":"Hardt","year":"2003","journal-title":"Pancreatol. Off. J. Int. Assoc. Pancreatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s11892-020-01304-0","article-title":"Exocrine Pancreatic Insufficiency in Type 1 and Type 2 Diabetes","volume":"20","author":"Radlinger","year":"2020","journal-title":"Curr. Diab Rep."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"891","DOI":"10.2337\/diab.34.9.891","article-title":"Insulin, via its own receptor, regulates growth and amylase synthesis in pancreatic acinar AR42J cells","volume":"34","author":"Logsdon","year":"1985","journal-title":"Diabetes"},{"key":"ref_49","first-page":"G155","article-title":"Regulation of pancreatic acinar cell insulin receptors by insulin","volume":"247","author":"Logsdon","year":"1984","journal-title":"Am. J. Physiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/MPA.0b013e31802f0531","article-title":"High glucose activates rat pancreatic stellate cells through protein kinase C and p38 mitogen-activated protein kinase pathway","volume":"34","author":"Nomiyama","year":"2007","journal-title":"Pancreas"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.2337\/diacare.18.11.1504","article-title":"Size of the pancreas in type I diabetic children and adolescents","volume":"18","author":"Chiarelli","year":"1995","journal-title":"Diabetes Care"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"83","DOI":"10.2337\/diab.8.2.83","article-title":"Observations on the pancreatic islet tissue of young diabetic subjects","volume":"8","author":"Maclean","year":"1959","journal-title":"Diabetes"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s00125-015-3752-z","article-title":"The influence of type 1 diabetes on pancreatic weight","volume":"59","author":"Kaddis","year":"2016","journal-title":"Diabetologia"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Li, K., Bian, J., Xiao, Y., Wang, D., Han, L., He, C., Gong, L., and Wang, M. (2023). Changes in Pancreatic Senescence Mediate Pancreatic Diseases. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24043513"},{"key":"ref_55","first-page":"681","article-title":"Exocrine pancreatic insufficiency and its consequences on physical development and metabolism in children and adolescents with type 1 diabetes mellitus","volume":"163","author":"Laass","year":"2004","journal-title":"Eur. J. Pediatr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1111\/j.1464-5491.2012.03597.x","article-title":"Pancreatic exocrine function in patients with diabetes","volume":"29","author":"Larger","year":"2012","journal-title":"Diabet. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.dsx.2021.04.023","article-title":"Prevalence of celiac disease in children with type 1 diabetes: A review","volume":"15","author":"Jalilian","year":"2021","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1002\/dmrr.708","article-title":"Pancreatin therapy in patients with insulin-treated diabetes mellitus and exocrine pancreatic insufficiency according to low fecal elastase 1 concentrations. Results of a prospective multi-centre trial","volume":"23","author":"Ewald","year":"2007","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.pan.2018.05.483","article-title":"Importance of pancreatic exocrine dysfunction in patients with type 2 diabetes: A randomized crossover study","volume":"18","author":"Lindkvist","year":"2018","journal-title":"Pancreatology"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1080\/003655201750422657","article-title":"Low faecal elastase 1 concentrations in type 2 diabetes mellitus","volume":"36","author":"Rathmann","year":"2001","journal-title":"Scand. J. Gastroenterol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/4\/1179\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:02:24Z","timestamp":1760104944000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/4\/1179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,19]]},"references-count":60,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["jcm13041179"],"URL":"https:\/\/doi.org\/10.3390\/jcm13041179","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,19]]}}}