docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2023-22-4-29-35docru-229Research ArticleКАРДИОМЕТАБОЛИЧЕСКАЯ МЕДИЦИНАCARDIOMETABOLIC MEDICINEСахарный диабет в исходе заболеваний поджелудочной железы — недостающее звено между сахарным диабетом 1 и 2 типовDiabetes Mellitus Outcome in Pancreatic Diseases the Missing Link between Type 1 and Type 2 Diabetes Mellitushttps://orcid.org/0000-0002-7936-7619АметовА. С.AmetovA. S.

Аметов Александр Сергеевич — д. м. н., профессор, заведующий кафедрой эндокринологии, заведующий сетевой кафедрой ЮНЕСКО по теме «Биоэтика сахарного диабета как глобальная проблема»

125993,  г. Москва, ул. Баррикадная, д. 2/1, стр. 1

2/1 Barrikadnaya Str., build. 1, Moscow, 125993

alexander.ametov@gmail.comhttps://orcid.org/0000-0003-1949-914XПашковаЕ. Ю.PashkovaE. Yu.

Пашкова Евгения Юрьевна  — к. м. н., доцент кафедры эндокринологии ; заведующаяотделением эндокринологии

125284, г. Москва, 2-й Боткинский пр-д, д. 5

2/1 Barrikadnaya Str., build. 1, Moscow, 125993; 5 2nd Botkinsky pr-d, Moscow,  125284

parlodel@mail.ruЕрохинаА. Г.ErokhinaA. G.

Ерохина Анна Геннадьевна — студентка 4 курса факультета ИКМ (институт клинической медицины)

119991, г. Москва, ул. Трубецкая, д. 8, стр. 2

8 Trubetskaya Str., build. 2, Moscow, 119991

https://orcid.org/0000-0002-0879-5333АмикишиеваК. А.AmikishievaA. K.

Амикишиева Ксения Андреевна  — аспирант кафедры эндокринологии; врач-эндокринолог

125284, г. Москва, 2-й Боткинский пр-д, д. 5

2/1 Barrikadnaya Str., build. 1, Moscow, 125993; 5 2nd Botkinsky pr-d, Moscow,  125284

isheryakova080795@mail.ruФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияRussian Medical Academy of Continuous Professional EducationRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации;  ГБУЗ «Городская клиническая больница имени С.П. Боткина Департамента здравоохранения города Москвы»РоссияRussian Medical Academy of Continuous Professional Education; Botkin HospitalRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202318022025224КАРДИОМЕТАБОЛИЧЕСКАЯ МЕДИЦИНА2935Copyright © Аметов А.С., Пашкова Е.Ю., Ерохина А.Г., Амикишиева К.А., 20252025Аметов А.С., Пашкова Е.Ю., Ерохина А.Г., Амикишиева К.А.Ametov A.S., Pashkova E.Y., Erokhina A.G., Amikishieva A.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/229Цель обзора

Цель обзора: изучить особенности патогенеза, диагностики и ведения пациентов с сахарным диабетом (СД), развившимся в исходе заболеваний экзокринной части поджелудочной железы (ДЭП).

Основные положения

Основные положения. ДЭП — распространенная проблема у пациентов с хроническим панкреатитом, раком поджелудочной железы, гемохроматозом, после панкреатэктомии. В статье рассматриваются различные аспекты данного типа диабета: его этиология, патогенез, особенности диагностики, важность постановки диагноза для правильного ведения больных. Представлен также сравнительный анализ нарушений взаимоотношения различных гормонов поджелудочной железы при ДЭП, их влияние на патогенез заболевания и клиническая значимость при дифференциальной диагностике ДЭП и СД 1 и 2 типов.

Заключение

Заключение. Рост заболеваемости хроническим и острым панкреатитом, лучшие показатели выживаемости у пациентов с раком поджелудочной железы с последующим развитием ДЭП привели к тому, что дифференциальная диагностика данного заболевания, разработка специфических клинических рекомендаций по ведению таких пациентов стали крайне актуальными. 

Aim

Aim: To study the features of pathogenesis, diagnosis and management of patients with diabetes, frolicking during various pathologies of the exocrine part of the pancreas.

Key points

Key points. Diabetes of the exocrine pancreas (DEP) is a common problem among patients with chronic pancreatitis, pancreatic cancer, hemochromatosis, after pancreatectomy. We discuss various aspects of this type of diabetes: its etiology, pathogenesis, diagnostic features, the importance of diagnosis for proper management. There are a comparative analysis of disorders of the relationship of various pancreatic hormones in DEP, their influence on the pathogenesis of the disease and clinical significance in the differential diagnosis of DEP with diabetes mellitus 1 and 2 types.

Conclusion

Conclusion. The increasing incidence of chronic and acute pancreatitis, better survival rates in patients with pancreatic cancer with the subsequent development of DEP, led to the evidence that the differential diagnosis of this disease, the development of guidelines for the management of such patients have become relevant. 

сахарный диабетсахарный диабет в исходе заболеваний экзокринной части поджелудочной железыострый панкреатитхронический панкреатитвнешнесекреторная недостаточность поджелудочной железыостровки ЛангергансасоматостатинглюкагонС-пептидамилинdiabetes mellitusdiabetes of the exocrine pancreasacute pancreatitischronic pancreatitisexocrine pancreatic insufficiencyislets of LangerhanssomatostatinglucagonC-peptideamylinReferencesДедов И.И., Шестакова М.В., Майоров А.Ю., ред. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. 10-й вып. М.; 2021. 148 c. DOI: 10.14341/DM12802Dedov I.I., Shestakova M.V., Mayorov A.Yu., eds. Standards of specialized diabetes care. 10th ed. M.; 2021. 148 p. (in Russian). DOI: 10.14341/DM12802Кононенко И.В., Смирнова О.М., Майоров А.Ю., Шестакова М.В. Классификация сахарного диабета. ВОЗ 2019 г. Что нового? Сахарный диабет. 2020;23(4):329–39. DOI: 10.14341/ DM12405Kononenko I.V., Smirnova O.M., Mayorov A.Yu., Shestakova M.V. Classification of diabetes. World Health Organization 2019. What’s new? Diabetes Mellitus. 2020;23(4):329–39. (in Russian). DOI: 10.14341/ DM12405Wei Q., Qi L., Lin H., Liu D. et al. Pathological mechanisms in diabetes of the exocrine pancreas: what's known and what's to know. Front. Physiol. 2020;11:570276. DOI: 10.3389/fphys.2020.570276Wei Q., Qi L., Lin H., Liu D. et al. Pathological mechanisms in diabetes of the exocrine pancreas: what's known and what's to know. Front. Physiol. 2020;11:570276. DOI: 10.3389/fphys.2020.570276Cui Y., Andersen D.K. Pancreatogenic diabetes: special considerations for management. Pancreatology. 2011;11(3):279–94. DOI: 10.1159/000329188Cui Y., Andersen D.K. Pancreatogenic diabetes: special considerations for management. Pancreatology. 2011;11(3):279–94. DOI: 10.1159/000329188Malka D., Hammel F., Sauvanet A., Rufat P. et al. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology. 2000;119(5):1324–32. DOI: 10.1053/gast.2000.19286Malka D., Hammel F., Sauvanet A., Rufat P. et al. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology. 2000;119(5):1324–32. DOI: 10.1053/gast.2000.19286Hardt P.D., Brendel M.D., Kloer H.U., Bretzel R.G. Is pancreatic diabetes (type 3c diabetes) underdiagnosed and misdiagnosed? Diabetes Care. 2008;31(suppl.2):S165–9. DOI: 10.2337/dc08-s244Hardt P.D., Brendel M.D., Kloer H.U., Bretzel R.G. Is pancreatic diabetes (type 3c diabetes) underdiagnosed and misdiagnosed? Diabetes Care. 2008;31(suppl.2):S165–9. DOI: 10.2337/dc08-s244Ciochina M., Balaban D.V., Manucu G., Jinga M. et al. The impact of pancreatic exocrine diseases on the β-cell and glucose metabolism — a review with currently available evidence. Biomolecules. 2022;12(5):618. DOI: 10.3390/biom12050618Ciochina M., Balaban D.V., Manucu G., Jinga M. et al. The impact of pancreatic exocrine diseases on the β-cell and glucose metabolism — a review with currently available evidence. Biomolecules. 2022;12(5):618. DOI: 10.3390/biom12050618Richardson A., Park W.G. Acute pancreatitis and diabetes mellitus: a review. Korean J. Intern. Med. 2021;36(1):15–24. DOI: 10.3904/ kjim.2020.505Richardson A., Park W.G. Acute pancreatitis and diabetes mellitus: a review. Korean J. Intern. Med. 2021;36(1):15–24. DOI: 10.3904/ kjim.2020.505Schrader H., Menge B.A., Schneider S., Belyaev O. et al. Reduced pancreatic volume and beta-cell area in patients with chronic pancreatitis. Gastroenterology. 2009;136(2):513–22. DOI: 10.1053/j.gastro.2008.10.083Schrader H., Menge B.A., Schneider S., Belyaev O. et al. Reduced pancreatic volume and beta-cell area in patients with chronic pancreatitis. Gastroenterology. 2009;136(2):513–22. DOI: 10.1053/j.gastro.2008.10.083Bellin M.D., Whitcomb D.C., Abberbock J., Sherman S. et al. Patient and disease characteristics associated with the presence of diabetes mellitus in adults with chronic pancreatitis in the United States. Am. J. Gastroenterol. 2017;112(9):1457–65. DOI: 10.1038/ajg.2017.181Bellin M.D., Whitcomb D.C., Abberbock J., Sherman S. et al. Patient and disease characteristics associated with the presence of diabetes mellitus in adults with chronic pancreatitis in the United States. Am. J. Gastroenterol. 2017;112(9):1457–65. DOI: 10.1038/ajg.2017.181Goodarzi M.O., Nagpal T., Greer P., Cui J. et al. Genetic risk score in diabetes associated with chronic pancreatitis versus type 2 diabetes mellitus. Clin. Transl. Gastroenterol. 2019;10(7):e00057. DOI: 10.14309/ctg.0000000000000057Goodarzi M.O., Nagpal T., Greer P., Cui J. et al. Genetic risk score in diabetes associated with chronic pancreatitis versus type 2 diabetes mellitus. Clin. Transl. Gastroenterol. 2019;10(7):e00057. DOI: 10.14309/ctg.0000000000000057Machicado J.D., Papachristou G.I. Pancreatogenic diabetes, acute pancreatitis management, and pancreatic tuberculosis: appraising the present and setting goals for the future. Unit. Eur. Gastroenterol. J. 2020;8(4):365–8. DOI: 10.1177/2050640620917017Machicado J.D., Papachristou G.I. Pancreatogenic diabetes, acute pancreatitis management, and pancreatic tuberculosis: appraising the present and setting goals for the future. Unit. Eur. Gastroenterol. J. 2020;8(4):365–8. DOI: 10.1177/2050640620917017Рагимов Р.М. Экзокринная функция и структурные особенности поджелудочной железы у пациентов с сахарным диабетом 1 и 2 типа: автореф. дис. ... канд. мед. наук. М.: ФГБУ «НМИЦ эндокринологии» Минздрава России; 2022. 25 с.Ragimov R.M. Exocrine function and structural features of pancreas in patients with type 1 and type 2 diabetes mellitus: abstract of cand. med. thesis. M.: Scientific and Research Institute of Endocrinology of the Ministry of Health of Russia; 2022. 25 p. (in Russian)Ebert R., Creutzfeldt W. Reversal of impaired GIP and insulin secretion in patients with pancreatogenic steatorrhea following enzyme substitution. Diabetologia. 1980;19(3):198–204. DOI: 10.1007/BF00275269Ebert R., Creutzfeldt W. Reversal of impaired GIP and insulin secretion in patients with pancreatogenic steatorrhea following enzyme substitution. Diabetologia. 1980;19(3):198–204. DOI: 10.1007/BF00275269Singh V.K., Haupt M.E., Geller D.E., Hall J.A. et al. Less common etiologies of exocrine pancreatic insufficiency. World. J. Gastroenterol. 2017;23(39):7059–76. DOI: 10.3748/wjg.v23.i39.7059Singh V.K., Haupt M.E., Geller D.E., Hall J.A. et al. Less common etiologies of exocrine pancreatic insufficiency. World. J. Gastroenterol. 2017;23(39):7059–76. DOI: 10.3748/wjg.v23.i39.7059Kunovský L., Dítě P., Jabandžiev P., Eid M. et al. Causes of exocrine pancreatic insufficiency other than chronic pancreatitis. J. Clin. Med. 2021;10(24):5779. DOI: 10.3390/jcm10245779Kunovský L., Dítě P., Jabandžiev P., Eid M. et al. Causes of exocrine pancreatic insufficiency other than chronic pancreatitis. J. Clin. Med. 2021;10(24):5779. DOI: 10.3390/jcm10245779Perbtani Y., Forsmark C.E. Update on the diagnosis and management of exocrine pancreatic insufficiency. F1000Res. 2019;8:F1000 Faculty Rev-1991. DOI: 10.12688/f1000research.20779.1Perbtani Y., Forsmark C.E. Update on the diagnosis and management of exocrine pancreatic insufficiency. F1000Res. 2019;8:F1000 Faculty Rev-1991. DOI: 10.12688/f1000research.20779.1Lan X., Robin G., Kasnik J., Wong G. et al. Challenges in diagnosis and treatment of pancreatic exocrine insufficiency among patients with pancreatic ductal adenocarcinoma. Cancers (Basel). 2023;15(4):1331. DOI: 10.3390/cancers15041331Lan X., Robin G., Kasnik J., Wong G. et al. Challenges in diagnosis and treatment of pancreatic exocrine insufficiency among patients with pancreatic ductal adenocarcinoma. Cancers (Basel). 2023;15(4):1331. DOI: 10.3390/cancers15041331Duggan S.N., Ewald N., Kelleher L., Griffin O. et al. The nutritional management of type 3c (pancreatogenic) diabetes in chronic pancreatitis. Eur. J. Clin. Nutr. 2017;71(1):3–8. DOI: 10.1038/ejcn.2016.127Duggan S.N., Ewald N., Kelleher L., Griffin O. et al. The nutritional management of type 3c (pancreatogenic) diabetes in chronic pancreatitis. Eur. J. Clin. Nutr. 2017;71(1):3–8. DOI: 10.1038/ejcn.2016.127Rickels M.R., Bellin M., Toledo F.G., Robertson R.P. et al. Detection, evaluation and treatment of diabetes mellitus in chronic pancreatitis: recommendations from PancreasFest 2012. Pancreatology. 2013;13(4):336–42. DOI: 10.1016/j.pan.2013.05.002Rickels M.R., Bellin M., Toledo F.G., Robertson R.P. et al. Detection, evaluation and treatment of diabetes mellitus in chronic pancreatitis: recommendations from PancreasFest 2012. Pancreatology. 2013;13(4):336–42. DOI: 10.1016/j.pan.2013.05.002Nils E., Hardt P.D. Diagnosis and treatment of diabetes mellitus in chronic pancreatitis. World J. Gastroenterol. 2013;19(42):7276–81. DOI: 10.3748/wjg.v19.i42.7276Nils E., Hardt P.D. Diagnosis and treatment of diabetes mellitus in chronic pancreatitis. World J. Gastroenterol. 2013;19(42):7276–81. DOI: 10.3748/wjg.v19.i42.7276Pal P., Pramanik S., Ray S. Editor’s Pick: Disorders of gastrointestinal motility in diabetes mellitus: an unattended borderline between diabetologists and gastroenterologists. EMJ Diabet. 2021;9(1):64– 74. DOI: 10.33590/emjdiabet/21-00155Pal P., Pramanik S., Ray S. Editor’s Pick: Disorders of gastrointestinal motility in diabetes mellitus: an unattended borderline between diabetologists and gastroenterologists. EMJ Diabet. 2021;9(1):64– 74. DOI: 10.33590/emjdiabet/21-00155Hieronymus L., Griffin S. Role of amylin in type 1 and type 2 diabetes. Diabetes Educ. 2015;41(1suppl.):47S–56S. DOI: 10.1177/0145721715607642Hieronymus L., Griffin S. Role of amylin in type 1 and type 2 diabetes. Diabetes Educ. 2015;41(1suppl.):47S–56S. DOI: 10.1177/0145721715607642Stanchev P.E., Orbetzova M.M., Terzieva D.D., Davcheva D.M. et al. Serum levels of incretin hormones — GLP-1 and GIP in patients with type 1 diabetes mellitus. Folia Med. (Plovdiv). 2019;61(1):76–83. DOI: 10.2478/folmed-2018-0056Stanchev P.E., Orbetzova M.M., Terzieva D.D., Davcheva D.M. et al. Serum levels of incretin hormones — GLP-1 and GIP in patients with type 1 diabetes mellitus. Folia Med. (Plovdiv). 2019;61(1):76–83. DOI: 10.2478/folmed-2018-0056Ghosh I., Mukhopadhyay P., Das K., Anne M.B. et al. Incretins in fibrocalculous pancreatic diabetes: a unique subtype of pancreatogenic diabetes. J. Diabetes. 2021;13(6):506–11. DOI: 10.1111/1753-0407.13139Ghosh I., Mukhopadhyay P., Das K., Anne M.B. et al. Incretins in fibrocalculous pancreatic diabetes: a unique subtype of pancreatogenic diabetes. J. Diabetes. 2021;13(6):506–11. DOI: 10.1111/1753-0407.13139Śliwińska-Mossoń M., Bil-Lula I., Marek G. The cause and effect relationship of diabetes after acute pancreatitis. Biomedicines. 2023;11(3):667. DOI: 10.3390/biomedicines11030667Śliwińska-Mossoń M., Bil-Lula I., Marek G. The cause and effect relationship of diabetes after acute pancreatitis. Biomedicines. 2023;11(3):667. DOI: 10.3390/biomedicines11030667Donowitz M., Hendler R., Spiro H.M., Binder H.J. et al. Glucagon secretion in acute and chronic pancreatitis. Ann. Intern. Med. 1975;83(6):778–81. DOI: 10.7326/0003-4819-83-6-778Donowitz M., Hendler R., Spiro H.M., Binder H.J. et al. Glucagon secretion in acute and chronic pancreatitis. Ann. Intern. Med. 1975;83(6):778–81. DOI: 10.7326/0003-4819-83-6-778Niwano F., Babaya N., Hiromine Y., Matsumoto I. et al. Glucose metabolism after pancreatectomy: opposite extremes between pancreaticoduodenectomy and distal pancreatectomy. J. Clin. Endocrinol. Metab. 2021;106(5):e2203–14. DOI: 10.1210/clinem/dgab036Niwano F., Babaya N., Hiromine Y., Matsumoto I. et al. Glucose metabolism after pancreatectomy: opposite extremes between pancreaticoduodenectomy and distal pancreatectomy. J. Clin. Endocrinol. Metab. 2021;106(5):e2203–14. DOI: 10.1210/clinem/dgab036Phillips A.R., Abu-Zidan F.M., Bonham M.J., Cooper G.J. et al. Amylin and severe acute pancreatitis. Pancreas. 2000;20(1):105–6. DOI: 10.1097/00006676-200001000-00015Phillips A.R., Abu-Zidan F.M., Bonham M.J., Cooper G.J. et al. Amylin and severe acute pancreatitis. Pancreas. 2000;20(1):105–6. DOI: 10.1097/00006676-200001000-00015Mezza T., Cefalo C.M.A., Cinti F., Quero G. et al. Endocrine and metabolic insights from pancreatic surgery. Trends Endocrinol. Metab. 2020;31(10):760–72. DOI: 10.1016/j.tem.2020.07.003Mezza T., Cefalo C.M.A., Cinti F., Quero G. et al. Endocrine and metabolic insights from pancreatic surgery. Trends Endocrinol. Metab. 2020;31(10):760–72. DOI: 10.1016/j.tem.2020.07.003Lund A. On the role of the gut in diabetic hyperglucagonaemia. Dan. Med. J. 2017;64(4):B5340. 32. Wilmer A. ICU management of severe acute pancreatitis. Eur. J. Intern. Med. 2004;15(5):274–280. DOI: 10.1016/j.ejim.2004.06.004Lund A. On the role of the gut in diabetic hyperglucagonaemia. Dan. Med. J. 2017;64(4):B5340. 32. Wilmer A. ICU management of severe acute pancreatitis. Eur. J. Intern. Med. 2004;15(5):274–280. DOI: 10.1016/j.ejim.2004.06.004Marques P., Barry S., Carlsen E., Collier D. et al. Pituitary tumour fibroblast-derived cytokines influence tumour aggressiveness. Endocr. Rel. Cancer. 2019;26(12):853–65. DOI: 10.1530/ERC-19-0327Marques P., Barry S., Carlsen E., Collier D. et al. Pituitary tumour fibroblast-derived cytokines influence tumour aggressiveness. Endocr. Rel. Cancer. 2019;26(12):853–65. DOI: 10.1530/ERC-19-0327Da Silva Xavier G. The cells of the islets of Langerhans. J. Clin. Med. 2018;7(3):54. DOI: 10.3390/jcm7030054Da Silva Xavier G. The cells of the islets of Langerhans. J. Clin. Med. 2018;7(3):54. DOI: 10.3390/jcm7030054Xu W., Zhou Y.F., Xia S.H. Octreotide for primary moderate to severe acute pancreatitis: a meta-analysis. Hepatogastroenterology. 2013;60(126): 1504–8.Xu W., Zhou Y.F., Xia S.H. Octreotide for primary moderate to severe acute pancreatitis: a meta-analysis. Hepatogastroenterology. 2013;60(126): 1504–8.Pendharkar S.A., Asrani V.M., Xiao A.Y., Yoon H.D. et al. Relationship between pancreatic hormones and glucose metabolism: a crosssectional study in patients after acute pancreatitis. Am. J. Physiol. Gastrointest. Liver Physiol. 2016;311(1):G50–8. DOI: 10.1152/ajpgi.00074.2016Pendharkar S.A., Asrani V.M., Xiao A.Y., Yoon H.D. et al. Relationship between pancreatic hormones and glucose metabolism: a crosssectional study in patients after acute pancreatitis. Am. J. Physiol. Gastrointest. Liver Physiol. 2016;311(1):G50–8. DOI: 10.1152/ajpgi.00074.2016Lytrivi M., Igoillo-Esteve M., Cnop M. Inflammatory stress in islet β-cells: therapeutic implications for type 2 diabetes? Curr. Opin. Pharmacol. 2018;43:40–5. DOI: 10.1016/j.coph.2018.08.002Lytrivi M., Igoillo-Esteve M., Cnop M. Inflammatory stress in islet β-cells: therapeutic implications for type 2 diabetes? Curr. Opin. Pharmacol. 2018;43:40–5. DOI: 10.1016/j.coph.2018.08.002Koopmans S.J., van Mansfeld A.D., Jansz H.S., Krans H.M. et al. Amylin-induced in vivo insulin resistance in conscious rats: the liver is more sensitive to amylin than peripheral tissues. Diabetologia. 1991;34(4):218–24. DOI: 10.1007/BF00405079Koopmans S.J., van Mansfeld A.D., Jansz H.S., Krans H.M. et al. Amylin-induced in vivo insulin resistance in conscious rats: the liver is more sensitive to amylin than peripheral tissues. Diabetologia. 1991;34(4):218–24. DOI: 10.1007/BF00405079Westwell-Roper C., Dai D.L., Soukhatcheva G., Potter K.J. et al. IL-1 blockade attenuates islet amyloid polypeptide-induced proinflammatory cytokine release and pancreatic islet graft dysfunction. J. Immunol. 2011;187(5):2755–65. DOI: 10.4049/jimmunol.1002854Westwell-Roper C., Dai D.L., Soukhatcheva G., Potter K.J. et al. IL-1 blockade attenuates islet amyloid polypeptide-induced proinflammatory cytokine release and pancreatic islet graft dysfunction. J. Immunol. 2011;187(5):2755–65. DOI: 10.4049/jimmunol.1002854Malaisse-Lagae F., Stefan Y., Cox J., Perrelet A. et al. Identification of a lobe in the adult human pancreas rich in pancreatic polypeptide. Diabetologia. 1979;17(6):361–5. DOI: 10.1007/BF01236270Malaisse-Lagae F., Stefan Y., Cox J., Perrelet A. et al. Identification of a lobe in the adult human pancreas rich in pancreatic polypeptide. Diabetologia. 1979;17(6):361–5. DOI: 10.1007/BF01236270Marchetti P., Lupi R., Bugliani M., Kirkpatrick C.L. et al. A local glucagon-like peptide 1 (GLP-1) system in human pancreatic islets. Diabetologia. 2012;55(12):3262–72. DOI: 10.1007/s00125-012-2716-9Marchetti P., Lupi R., Bugliani M., Kirkpatrick C.L. et al. A local glucagon-like peptide 1 (GLP-1) system in human pancreatic islets. Diabetologia. 2012;55(12):3262–72. DOI: 10.1007/s00125-012-2716-9English A., Irwin N. Nonclassical islet peptides: pancreatic and extrapancreatic actions. Clin. Med. Insights Endocrinol. Diabetes. 2019;12:1179551419888871. DOI: 10.1177/1179551419888871English A., Irwin N. Nonclassical islet peptides: pancreatic and extrapancreatic actions. Clin. Med. Insights Endocrinol. Diabetes. 2019;12:1179551419888871. DOI: 10.1177/1179551419888871

The authors declare that there are no conflicts of interest present.