Pancreatin Added to Standard Antihyperglycemic Therapy in Patients With Type 2 Diabetes

Medications that enhance the incretin effect (GLP-1 receptor agonists, tirzepatide (GIP/GLP-1 receptor agonist) and DPP-4 inhibitors) are used in treatment of patients with type 2 diabetes. GLP-1 agonists and tirzepatide not only effectively lower blood glucose levels but also promote weight loss-primarily by stimulating the satiety center in the central nervous system - and reduce cardiovascular risk. Evidence suggests that oral pancreatin supplementation also enhances the incretin effect by increasing GIP and GLP-1 concentrations, and consequently insulin levels, which translates into a reduction in postprandial glycemia in patients with cystic fibrosis or chronic pancreatitis. In our study we aim to evaluate the impact of pancreatin on the incretin effect and glycemic control in patients with type 2 diabetes without exocrine pancreatic insufficiency.

Inclusion Criteria: * Type 2 diabetes diagnosed for at least 12 months * Patients treated with oral antihyperglycemic agents and/or insulin as monotherapy or combination therapy * Age between 35 and 75 years * HbA1c: 6.5% - 9.0% Exclusion Criteria: * Type 1 diabetes * Use of incretin-based drugs (GLP-1 receptor agonists, dual GIP and GLP-1 receptor agonists, DPP-4 inhibitors) currently or within the last 3 months * History of pancreatic surgery * History of chronic pancreatitis * History of acute pancreatitis