Characteristics of pancreatic diabetes in patients with autoimmune pancreatitis

Abstract

OBJECTIVE:Although patients with autoimmune pancreatitis (AIP) tend to have concurrent diverse disorders, very few studies have focused on diabetes mellitus (DM) coexisting with AIP. METHODS:In total 102 AIP patients with DM were divided into three groups. Those with DM before the onset of AIP were labeled group A (n = 35), those who developed DM and AIP simultaneously were labeled group B (n = 58) and those who developed DM after steroid therapy for AIP were labeled group C (n = 9). The characteristics of DM among the three groups were evaluated. RESULTS:No significant differences were noted in the age of DM onset among the three groups. However, the mean duration of DM was significantly longer in group A (8.7 years) than in groups B and C.AIP developed 6.8 years after DM onset in group A, whereas it developed 1.8 years after steroid therapy in group C. Group A had the highest rate (25.7%) of family members with a history of AIP. Levels of serum albumin, total cholesterol and triglyceride were significantly lower in group A. No correlations were found between glycated hemoglobin and benzoyltyrosyl para-aminobenzoic acid. Hypoglycemia was observed in 20% of patients under insulin therapy. Most of them were habitual drinkers and received no pancreatic enzymes. Group A showed a high prevalence of retinopathy, nephropathy and macrovascular disorders than group B.CONCLUSION: Aspects of AIP-associated pancreatic diabetes were clarified. AIP-associated DM must be controlled by a full assessment of the pancreatic endocrine and exocrine function.

Type 1 Autoimmune Pancreatitis in a Young Male

“…A significant implication of AIP is secondary DM. A study conducted in Japan showed a high proportion of micro (retinopathy, nephropathy) and macrovascular complications in patients who had DM prior to the diagnosis of AIP [11].…”

Features of and Mechanisms Underlying Insulitis In <i>aly/aly</i> MaleMice as an Animal Model of Autoimmune Pancreatitis: Activation of CD11c⁺, CD4⁺, and Th2 Cells and Predominant Destruction of β-cells

“…In AIP, disorders of pancreatic exocrine and endocrine function are often present, and DM and IGT are observed in many cases [5][6][7][8] ; this is believed to be due to the effect of both blood flow obstruction of the endocrine gland accompanying formation of exocrine gland brosis and insulitis 18 . We have used aly mice as a mouse model of AIP in previous studies 19 20 .…”

“…Furthermore, the involvement of other organs in pancreatitis seems to extend systemically to various organs, suggesting that AIP is an IgG4-related systemic disease 3 4 , with IgG4-related disease 5 recognized as a new entity. In AIP, disorders of both pancreatic exocrine and endocrine function are often induced, and many patients have either diabetes mellitus DM and/or impaired glucose tolerance IGT [6][7][8][9] .…”

Diabetes mellitus asociada a pancreatitis autoinmune: Caso clínico

“…A lrededor de 60-70% de los pacientes con pancreatitis autoinmune (PAI) presenta diabetes mellitus (DM) y su diagnóstico es simultáneo en más de 50% de ellos 1,2 . Presentamos el caso de un paciente adulto mayor que debuta con DM, en contexto de la aparición de un cuadro compatible con PAI, experimentando una notable mejoría de su control metabólico con la terapia esteroidal de su enfermedad pancreática.…”