A 41-yeаr-оld mаn with аlcоhоl use disorder has recurrent upper abdominal pain, weight loss, steatorrhea, and newly elevated glucose. He reports stools that are bulky and difficult to flush. Lipase is mildly elevated at 115 U/L (normal: approximately 0–160 U/L), and fasting glucose is 148 mg/dL (normal: 70–99 mg/dL). The NP bases the plan of care on the understanding that chronic pancreatic inflammation can lead to which pathophysiologic consequence?