Factors Affecting the Development of Diabetes Mellitus After Pancreatic Resection

Kwon, Jae‐Hyun; Kim, Song Cheol; Shim, In Kyong; Song, Ki Byung; Lee, Jae Hoon; Hwang, Dae Wook; Park, Kwang-Min; Lee, Young‐Joo

doi:10.1097/mpa.0000000000000404

Cited by 49 publications

(71 citation statements)

References 22 publications

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“…This finding may be associated with our results, in which the pancreatic volume reduction at 6 and 12 months after PD is related to new onset DM. Similar results have been reported by Kwon et al [15] They described that the mean time interval between pancreatic resection and onset of DM was 16.8 months and suggested that careful analysis of glucose metabolism parameters is necessary, especially at approximately 16 months after pancreatic resection.…”

Section: Discussionsupporting

confidence: 89%

“…There have been various results from studies on the occurrence of new onset DM after PD, with the incidence reported between 0% and 50%. [3,6–15] In this study, we report that PD led to glucose impairment, and postoperative NODM developed in 24.2% of nondiabetic patients who underwent PD. This result is consistent with the previous literature on the incidence of new onset DM after PD.…”

Section: Discussionmentioning

confidence: 83%

“…[10] CT volumetry is a reliable method for estimating the endocrine function of the remnant pancreas. [3,15] Some studies have analyzed the relationship between volume status (resection volume or remnant volume) and new onset DM and have shown that the pancreatic volume status after surgery did not significantly predict new onset DM. [10,15] …”

Section: Discussionmentioning

confidence: 99%

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Does the pancreatic volume reduction rate using serial computed tomographic volumetry predict new onset diabetes after pancreaticoduodenectomy?

Yun

Seo²,

Kim³

et al. 2017

Medicine

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Volume reduction of the pancreatic tissues following a pancreatectomy can lead to the deterioration of glucose homeostasis. This is defined as pancreatogenic diabetes mellitus (DM). The objective of this study was to investigate the occurrence of new-onset DM (NODM) and evaluate the risk factors, including the pancreas volume reduction rate in patients undergoing pancreaticoduodenectomy (PD).Sixty-six patients without preoperative DM underwent PD for periampullary tumors between August 2007 and December 2012 and were included in this analysis. These patients underwent follow-up tests and abdominal computed tomography (CT) scan 7 days, 6 months, 12 months, 24 months, and 36 months after the operation. The pancreas volume reduction rate was calculated by CT volumetry. The patients were divided into 2 groups according to the postoperative development of DM.After PD, newly diagnosed DM occurred in 16 patients (24.2%). The incidence of DM was highest among patients with carcinomas with an advanced T stage. The pancreatic volume reduction rate after 6 and 12 months in the NODM group was significantly higher than the normal glucose group in the univariate analysis. In the multivariate analysis, the pancreatic volume reduction rate 6 months after PD was the only significant predictive factor for the development of NODM (P = 0.002).This study suggests that the pancreatic volume reduction rate 6 months after PD was the only significant predictive factor for the development of NODM. CT volumetry of the pancreas may be useful as a predictor of NODM after PD.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Does the pancreatic volume reduction rate using serial computed tomographic volumetry predict new onset diabetes after pancreaticoduodenectomy?

Yun

Seo²,

Kim³

et al. 2017

Medicine

View full text Add to dashboard Cite

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“…Sample sizes in individual studies ranged from 20 to 4775 patients, with a total of 9970 patients included for analysis. Table summarizes the study characteristics and key results for the included studies . These studies included 5636 patients undergoing pancreaticoduodenectomy, 3922 patients with distal pancreatectomy and 315 undergoing central pancreatectomy.…”

Section: Resultsmentioning

confidence: 99%

Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

Nahm

Jamieson

et al. 2020

Clinical Endocrinology

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Objectives: Type 3c diabetes mellitus (T3cDM) occurring post pancreatectomy can be challenging to treat due to the frequent combination of decreased circulating levels of insulin and glucagon and concurrent exocrine insufficiency. Relatively, little is known regarding the risk factors for development of T3cDM post pancreatectomy. Our aim was to review the literature and assess what is known of the risk factors for the development of new-onset DM following partial pancreatic resection and where possible determines the incidence, time of onset and the management approach to hyperglycaemia in this context. Design: Medline and Embase databases were reviewed using specific keyword criteria. Original manuscripts published in 1990 or later included. Articles with study population <20, lacking information on new-onset DM, follow-up duration or specifically targeting rare procedures/pathology were excluded. The Newcastle Ottawa Quality Assessment form was applied. Results reported according to PRISMA guidelines. Pooled effect size calculated using random effects model. Patients: Thirty six articles were identified that described a total of 5636 patients undergoing pancreaticoduodenectomy, 3922 patients having distal pancreatectomy and 315 with central pancreatectomy.Results: The incidence of new-onset DM was significantly different between different types of resection from 9% to 24% after pancreaticoduodenectomy (pooled estimate 16%; 95% CI: 14%-17%), 3%-40% after distal pancreatectomy (pooled estimate 21%; 95% CI: 16%-25%) and 0%-14% after central pancreatectomy (pooled estimate 6%; 95% CI: 3%-9%). Surgical site, higher preoperative HbA1c, fasting plasma glucose and lower remnant pancreatic volume had strongest associations with new-onset DM.Conclusions: This systematic review supports that risk of development of T3cDM is associated with type of pancreatic resection, lower remnant pancreatic volume and higher preoperative HbA1c. K E Y W O R D Sdiabetes mellitus, pancreatectomy, pancreatic insufficiency, pancreaticoduodenectomy, Whipple's procedure | 397 WU et al.

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“…Some dogs develop transient hyperglycemia, whereas a smaller number of dogs develop persistent DM requiring long‐term administration of insulin . In human medicine, prevalence of postpancreatectomy DM varies from 5 to 78% depending on the heterogeneity of the population studied . The largest study revealed a median prevalence of 23% .…”

Section: Introductionmentioning

confidence: 99%

Incidence of postoperative complications and outcome of 48 dogs undergoing surgical management of insulinoma

Busto

German

Treggiari

et al. 2020

Veterinary Internal Medicne

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Background: Information regarding outcome of dogs undergoing surgical management for insulinoma is based on studies of a small number of dogs.Objectives: To report the outcomes of dogs undergoing surgery as treatment for insulinoma, the prevalence of postoperative diabetes mellitus (DM) in this group and to determine if development of DM can be predicted. Animals: Forty-eight client-owned dogs, with a histopathological diagnosis of insulinoma, from three European referral hospitals. Methods: Retrospective observational study. Dogs were identified from a search of electronic hospital records. Cox's regression was used to determine factors associated with postoperative survival and relapse, and logistic regression was used to determine factors associated with the development of DM. Results: Median survival time (MST) was 372 days (range 1-1680 days), with dogs with stage I disease having the longest survival time. Stage I dogs had MST of 652 days (range 2-1680 days), whereas dogs with either stage II or III disease had MST of 320 days (range 1-1260 days; P = 0.045). Postoperative hyperglycemia was identified in 33% (16/48) of the dogs, of which 9 (19% of the total population) developed persistent DM. No factors that could be used as predictors for development of DM were identified.Conclusions and clinical importance: Stage of disease and postoperative hypoglycemia were associated with greater odds of relapse and decreased survival time; these could be used when discussing prognosis. In this study, postoperative DM developed more commonly than previously reported, but no factors were identified that might be useful predictors.

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Factors Affecting the Development of Diabetes Mellitus After Pancreatic Resection

Cited by 49 publications

References 22 publications

Does the pancreatic volume reduction rate using serial computed tomographic volumetry predict new onset diabetes after pancreaticoduodenectomy?

Does the pancreatic volume reduction rate using serial computed tomographic volumetry predict new onset diabetes after pancreaticoduodenectomy?

Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

Incidence of postoperative complications and outcome of 48 dogs undergoing surgical management of insulinoma

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