Diabetes mellitus, a common complication of
chronic pancreatitis, can disturb the metabolism of
zinc,
copper, and
selenium. We analyzed the effects of
hyperglycemia, malabsorption, and dietary intake on these factors in 35 men with alcohol-induced
chronic pancreatitis complicated by
insulin-treated
diabetes mellitus (CP-D), 12 men with
chronic pancreatitis but no diabetes (nondiabetic CP), 25 men with
type 1 diabetes mellitus (type 1 DM), and 20 control subjects. Diabetes due to
chronic pancreatitis was associated with decreased plasma
zinc and
selenium concentrations and with increased urinary
copper excretion. Of the
chronic pancreatitis patients, 17% had low plasma
zinc, and 41% of them had low plasma
selenium. None of the type 1 diabetic patients had low plasma concentrations of
zinc, but 12% of them had a low
selenium concentration.
Hyperglycemia, as assessed by fasting plasma
glucose and by plasma HbAlc, was responsible for the increased
zinc excretion and the decreased
superoxide dismutase activity. The perturbations of the
copper,
selenium, and
zinc metabolism were particularly pronounced in subjects with
chronic pancreatitis plus
diabetes mellitus. We have yet to determine whether the differences in
trace-element status contribute to the clinical expression of the disease.