Abstract

Background: Fibrocalculous pancreatic diabetes (FCPD) is an uncommon form of diabetes secondary to nonalcoholic chronic calcific pancreatitis of uncertain etiology predominantly found in tropical regions of the world, characterized by abdominal pain and pancreatic calcification. The term “Fibrocalculous Pancreatic Diabetes” was introduced by the World Health Organization Report in 1985.

Objective: To study prevalence and clinical presentation of FCPD in and around Jabalpur (Madhya Pradesh) Central India.

Materials and Methods: A total of 891 cases of diabetes mellitus came from in and around Jabalpur and were presented at the OPD of Department of Medicine, Sukh-Sagar Medical College and Hospital between December 2014 and April 2016 and they were included in the study with informed consent. Subjects were put to detailed history, clinical, and laboratory workup including body mass index, blood sugar level (fasting, postprandial), HbA1c, USG, and plain X-ray abdomen and defined criteria were used for diagnosis of FCPD.

Result: Of the total enrolled cases of 891, 94.05% of cases of T2DM, 5.61% of cases of T1DM, and only 0.34% of cases of FCPD were found. All 100% of cases of FCPD belonged to 35–45 years of age group, low socioeconomical status, and consumed high percentage of carbohydrates as a main source of diet. Abdominal pain was one of the main complaints found in all three patients of FCPD whereas two (66.6%) cases whose plain X-ray abdomen revealed pancreatic calcification were chronic alcoholic. When we investigated further, we found that all the three cases of FCPD had the highest basal, postprandial blood glucose levels, as well as poor glycemic control (HbA1c >7), and mainly (66.6%) responded to insulin therapy.

Conclusion: The prevalence rate of FCPD was found to be 0.34% in and around Jabalpur (Central India) that is lower than Southern India’s prevalence rate, probably on account of the economic development, difference in dietary habits, and better levels of malnutrition. Even though the etiology remains unknown more studies need to be conducted to understand the exact nature of the pancreatic pathology in FCPD, what triggers it and if, and how, the process can be arrested, before the development of diabetes.

Key words: Fibrocalculous pancreatic diabetes (FCPD), secondary diabetes, chronic pancreatitis, tropical chronic (calcific) pancreatitis