Researchers studied whether a digestive enzyme supplement called pancreatin could help people with type 2 diabetes control their blood sugar better. They followed 256 patients—half taking pancreatin and half not taking it—and measured their blood sugar levels over time. The group taking pancreatin showed slightly better improvements in blood sugar control, especially those whose pancreases weren’t working as well as they should. The study also found benefits for triglycerides (a type of fat in the blood) and vitamin D levels. While the improvements were modest, this research suggests that pancreatin might help certain diabetes patients, particularly those with pancreatic function problems.

The Quick Take

  • What they studied: Whether taking a pancreatic enzyme supplement (pancreatin) helps people with type 2 diabetes control their blood sugar better, and whether it works better for people whose pancreases aren’t functioning normally.
  • Who participated: 256 adults with type 2 diabetes—128 who were prescribed pancreatin and 128 similar patients who weren’t taking it. Researchers matched the groups to make them as similar as possible before the study started.
  • Key finding: Patients taking pancreatin had slightly better blood sugar improvements (1.3% drop) compared to those not taking it (1.1% drop). The benefit was strongest in people whose pancreases showed signs of not working well, particularly those with very low pancreatic enzyme levels.
  • What it means for you: If you have type 2 diabetes and your doctor suspects your pancreas isn’t digesting food properly, pancreatin might be worth trying as an add-on treatment. However, this is a modest benefit, not a replacement for other diabetes medications or lifestyle changes. Talk to your doctor about whether testing your pancreatic function makes sense for you.

The Research Details

This was a retrospective cohort study, meaning researchers looked back at medical records of patients who had already been treated. They compared 128 patients who received pancreatin (a supplement containing digestive enzymes from pig pancreas) with 128 carefully matched patients who didn’t receive it. To make the comparison fair, researchers used a statistical method called propensity matching to ensure the two groups were similar in important ways like age, weight, and baseline diabetes severity.

Researchers measured how well each patient’s pancreas was working using a test called fecal elastase-1 (FE-1), which checks for pancreatic enzymes in stool samples. This test helped them understand which patients might benefit most from pancreatin. They tracked blood sugar control using HbA1c (a measure of average blood sugar over 3 months), plus other markers like fasting glucose, triglycerides, liver function, and vitamin D levels.

The study used advanced statistical analysis to look for interactions—meaning they checked whether pancreatin worked differently depending on how well someone’s pancreas was functioning. This allowed them to identify which patients benefited most from the treatment.

This research approach matters because it recognizes that type 2 diabetes isn’t one-size-fits-all. Some people with diabetes also have pancreatic problems that make it harder to digest food and absorb nutrients. By measuring pancreatic function and looking at how it affects treatment response, this study moves toward personalized medicine—giving treatments to people most likely to benefit. The retrospective design is practical and cost-effective, though it’s not as strong as a randomized trial.

Strengths: The study used propensity matching to create fair comparison groups, included a reasonable sample size (256 patients), and measured multiple health markers beyond just blood sugar. The researchers looked for interactions between treatment and pancreatic function, which is sophisticated analysis. Limitations: This was a retrospective study using existing medical records, so researchers couldn’t control all variables as tightly as in a randomized trial. The study was conducted at a single center, so results may not apply everywhere. There’s no information about how long patients took pancreatin or whether they stuck with it consistently.

What the Results Show

Both groups of patients showed improvements in blood sugar control over the study period, which is typical when diabetes is being actively managed. However, the pancreatin group had a slightly larger improvement: their HbA1c (average blood sugar marker) dropped by 1.3% compared to 1.1% in the control group. While this difference seems small, it was statistically significant, meaning it’s unlikely to have happened by chance.

The most important finding was that pancreatin worked best for specific patients: those whose pancreases weren’t producing enough digestive enzymes. When researchers looked at the fecal elastase-1 test results, they found that patients with very low pancreatic enzyme levels (below 80 µg/g) got the most benefit from pancreatin. In fact, patients with the lowest pancreatic function showed the most pronounced improvements in blood sugar control.

The study also found that baseline blood sugar levels mattered—patients who started with higher blood sugar levels tended to see bigger improvements. This makes sense because there’s more room for improvement when starting from a higher point.

Beyond blood sugar control, pancreatin also appeared to help with other health markers. Patients taking pancreatin showed improvements in triglycerides (a type of fat in the blood that’s often elevated in diabetes) and vitamin D levels. These secondary benefits make sense because pancreatin helps with fat and nutrient absorption, and vitamin D is a fat-soluble vitamin that requires proper digestion to be absorbed effectively.

This research adds to growing evidence that pancreatic function problems are more common in type 2 diabetes than previously recognized. Previous studies have shown that some people with diabetes have reduced pancreatic enzyme production, but few studies have tested whether supplementing with pancreatin actually improves outcomes. This study is among the first to show that pancreatin may help, particularly when targeted to people with documented pancreatic dysfunction. The findings align with the theory that poor digestion and nutrient absorption can worsen diabetes control.

The study has several important limitations. First, it’s retrospective, meaning researchers looked at past medical records rather than following patients forward in a controlled way. This makes it harder to prove that pancreatin caused the improvements rather than other factors. Second, the study was conducted at a single medical center, so results may not apply to all populations or healthcare settings. Third, there’s no information about how consistently patients took pancreatin or whether they changed their diets or medications during the study. Fourth, the improvements in blood sugar, while real, were modest—about 0.2% difference between groups. Finally, the study didn’t include a placebo group, so we can’t rule out placebo effects.

The Bottom Line

Based on this research, pancreatin may be worth considering as an add-on treatment if: (1) you have type 2 diabetes that’s not well-controlled despite other treatments, AND (2) your doctor finds evidence that your pancreas isn’t producing enough digestive enzymes. The evidence is moderate—this is not a strong recommendation, but rather a ‘may help’ suggestion. Pancreatin should never replace standard diabetes medications like metformin or insulin, nor should it replace healthy eating and exercise. If you’re interested, ask your doctor about fecal elastase-1 testing to check your pancreatic function.

This research is most relevant for people with type 2 diabetes who have symptoms of poor digestion (bloating, fatty stools, nutrient deficiencies) or who aren’t reaching their blood sugar goals despite medication. It’s less relevant for people whose diabetes is well-controlled or those without pancreatic problems. People with type 1 diabetes or other types of diabetes should discuss this separately with their doctors, as the findings may not apply. Anyone considering pancreatin should talk to their healthcare provider first, especially if they’re taking other medications.

Based on this study, improvements in blood sugar control would likely take several weeks to a few months to become noticeable, since HbA1c measures average blood sugar over 3 months. You wouldn’t see immediate changes. Benefits in triglycerides and vitamin D might take even longer—typically 2-3 months or more. If pancreatin is going to help you, your doctor would typically reassess after 2-3 months using blood tests.

Want to Apply This Research?

  • If your doctor prescribes pancreatin, track your fasting blood sugar readings each morning before eating, and log them weekly in your app. Also note any changes in digestion (bloating, stool consistency) and energy levels. This helps you and your doctor see if pancreatin is actually helping your individual situation.
  • Set a daily reminder to take pancreatin with meals (as directed by your doctor), and use your app to log when you take it. This builds consistency and helps you remember to take it properly. Also track your meals to see if better digestion correlates with better blood sugar readings.
  • Plan to check your HbA1c level with your doctor every 3 months while taking pancreatin. Use your app to track trends in fasting glucose readings over weeks and months. If you see improvement after 2-3 months, continue the treatment. If you see no improvement after 3 months, discuss with your doctor whether to stop or adjust the dose. Keep notes about any side effects or digestive changes.

This research describes a modest benefit of pancreatin for some people with type 2 diabetes, but it is not a substitute for standard diabetes treatment. Pancreatin should only be used under medical supervision and as prescribed by your doctor. This study does not prove that pancreatin will help you personally—individual results vary greatly. Do not start, stop, or change any diabetes medications or supplements without talking to your healthcare provider first. If you have symptoms of pancreatic problems or poorly controlled diabetes, consult your doctor about appropriate testing and treatment options. This summary is for educational purposes and should not be considered medical advice.