PECULIARITIES OF FORMATION OF CARBOHYDRATE METABOLISM DISORDERS WITH COMORBID CHRONIC PANCREATITIS AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE

The aim: To determine glycemic condition, regulation of carbohydrate metabolism, degree of insulin resistance in patients with chronic pancreatitis with its isolated course and with comorbid COPD and diabetes mellitus. Materials and methods: 110 patients with chronic pancreatitis were examined. The first group of patients included 38 individuals with an isolated course of chronic pancreatitis (1 group), 2nd group included 35 patients with chronic pancreatitis and COPD, 3rd group included 37 patients with chronic pancreatitis and COPD and type 3c diabetes mellitus. The control group (CCOPD) included 32 individuals with isolated COPD, the control group (CDM) includes 34 individuals with isolated type 2 diabetes mellitus. All the patients were examined for functional state of the pancreas and carbohydrate metabolism was assessed. Results: Patients suffering from chronic pancreatitis with COPD and diabetes mellitus developed 3.2 times increased glucose concentration on an empty stomach. Blood glucagon content in all patients was lower in comparison with that of practically healthy individuals which is indicative of an insufficient glucagon secretion by α-cells of the pancreas. Pancreatic polypeptide content in the blood was lower in patients with chronic pancreatitis and COPD and T3c diabetes mellitus in comparison with the reference value. Conclusions: A comorbid course of chronic pancreatitis with exacerbated COPD is associated with more intensive disturbances in carbohydrate metabolism regulation and glycaemia parameters in comparison with an isolated course of chronic pancreatitis. In case comorbidity includes a chronic pancreatitis, chronic obstructive pulmonary disease and diabetes mellitus, the most unfavorable glycemic profile is found which is indicative of carbohydrate metabolism decompensation.