Adjunctive pancreatin therapy enhances glycemic and metabolic outcomes in type 2 diabetes mellitus: the modifying role of exocrine pancreatic function
Authors' conclusion
Adjunctive pancreatin provides modest glycemic benefit in T2DM, primarily in patients with severe exocrine dysfunction. Targeted use guided by FE-1 testing may enable a more personalized therapeutic strategy.
Study context
- Population
- Patients with T2DM; FE-1 used to assess exocrine reservepropensity-matched
- Participants
- 256 patients
- Exposure
- Adjunctive pancreatin vs propensity-matched controls
- Pancreatinn = 128
- Controlsn = 128reference
- Outcome
- HbA1c change
Methodological detailspropensity-matched
- Propensity-matched
Main finding
As reported in the abstract
Pancreatin
−1.3
± 1.0 · %
Controls
−1.1
± 0.9 · %
P = 0.014
Observational data: associations, not effects.
Secondary outcomes
Predictors of HbA1c change (multivariable regression)
- Baseline HbA1c, β (p < 0.001)
- 0.419
- FE-1, β (p < 0.001)
- −0.0025
- Treatment × FE-1 interaction, β (p < 0.001); incremental benefit of pancreatin emerged below ∼ 80 µg/g
- −0.0088
HbA1c change by FE-1 subgroup
- Patients with FE-1 < 100 µg/g exhibited the most pronounced glycemic improvements
Triglycerides and vitamin D
- Secondary benefits in triglycerides and vitamin D were observed
Original publication
Adjunctive pancreatin therapy enhances glycemic and metabolic outcomes in type 2 diabetes mellitus: the modifying role of exocrine pancreatic function. Diabetes Res Clin Pract. Published 12 October 2025. doi:10.
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