High prevalence of low faecal elastase levels in individuals with type 1 diabetes is associated with diabetes duration but not with marked alterations in food intake or clinical symptoms
Authors' conclusion
The lack of evidence for associations with clinical parameters in this relatively healthy population of individuals with type 1 diabetes does not support the use of FE for routine screening for EPI.
Study context
- Population
- Individuals with T1D (62% female, median age 42 years [IQR 29–54], mean BMI 25±4 kg/m², median diabetes duration 16 years [IQR 6–29])
- Participants
- 443 individuals
- Outcome
- Association of faecal elastase (FE) levels, as a marker of exocrine pancreatic insufficiency (EPI), with T1D parameters and clinical features
Methodological detailscohort, linear and Poisson regression models
- Cohort
- Linear and Poisson regression models
Main finding
As reported in the abstract
FE levels and variables independently associated with lower FE
- Mean faecal elastase (FE) level (±SD), µg/g faeces
- 349.5±146.8
- Older age: µg/g faeces per 10 years
- −10.97 (95% CI −21.02, −0.92)
- Longer diabetes duration: µg/g per 10 years
- −13.09 (95% CI −23.54, −2.64)
- Higher HbA1c: mmol/mol per 1 SD increase in FE levels
- −1.44 (95% CI −2.59, −0.30)
- Male sex: µg/g
- −54.07 (95% CI −81.41, −26.73)
- Smoking: µg/g
- −85.06 (95% CI −128.52, −41.60)
Observational data: associations, not effects.
Further findings
Exocrine pancreatic insufficiency (EPI) (FE cut-off 200 µg/g faeces): prevalence and associations
- Individuals with EPI
- 76 (17%)
- Higher HbA1c with EPI, mmol/mol (0.39%)
- 4.31 (95% CI 1.35, 7.26)
- Higher mean glucose with EPI
- 8% (95% CI 2, 14)
- Lower fibre intake with EPI
- 9% (95% CI 1, 17)
- Lower energy intake with EPI
- 8% (95% CI 1, 15)
Original publication
High prevalence of low faecal elastase levels in individuals with type 1 diabetes is associated with diabetes duration but not with marked alterations in food intake or clinical symptoms. Diabetologia. Published 8 August 2026. doi:10.
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