Hyperglycemia and Diabetes Mellitus in Children with Pancreatitis

Raman, Vandana; Loar, Robert W.; Renukuntla, Venkat S.; Hassan, Krishna; Fishman, Douglas S.; Gilger, Mark A.; Heptulla, Rubina A.

doi:10.1016/j.jpeds.2010.09.066

Cited by 18 publications

(15 citation statements)

References 27 publications

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“…Up to 50% of patients with AP have an elevated blood sugar level [3,5,6]. In these patients hyperglycaemia may be caused by decreased insulin secretion, parenteral nutritional therapy, increased gluconeogenesis and decreased glucose use [3].…”

Section: Discussionmentioning

confidence: 99%

“…For example, temporary hyperglycaemia can be observed in up to 50% of patients with AP, persistent diabetes may affect 1-15% of patients with AP, and the prevalence of diabetes in chronic pancreatitis varies between 30% and 83%, depending on the study [5,6]. This correlation is usually explained by the accepted fact that pancreatitis can cause the development of diabetes mellitus [3].…”

Section: Introductionmentioning

confidence: 99%

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Diabetes aggravates acute pancreatitis and inhibits pancreas regeneration in mice

et al. 2012

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Aims/hypothesis It is well established that acute pancreatitis often causes diabetes and that a high blood glucose level associated with pancreatitis is a marker of poor prognosis. The aim of this study was to evaluate if diabetes merely reflects the severity of pancreatitis or whether it can also aggravate the progression of this disease in a vicious circle. Methods Reversible acute oedematous pancreatitis was induced in untreated and streptozotocin-treated diabetic mice by injection of cerulein. Progression of pancreatitis was studied by immunohistochemistry, ELISA and various other enzyme assays. The production of regenerating isletderived 3β (REG3β) was determined by western blot and immunohistochemistry. Results While cerulein treatment in non-diabetic mice resulted in acute pancreatitis followed by regeneration of the pancreas within 7 days, diabetes aggravated pancreatitis, inhibited the regeneration of the exocrine tissue and led to strong atrophy of the pancreas. The aggravation of pancreatitis by diabetes was characterised by decreased production of the anti-inflammatory protein REG3β, increased inflammation, augmented oedema formation and increased cell death during the acute phase of pancreatitis (p < 0.05). During the regenerative phase, diabetes augmented inflammation, increased cell death, reduced acinar cell expansion and increased the expansion of duct as well as interstitial cells, resulting in the formation of tubular complexes (p<0.05). Administration of insulin reversed the observed phenotype in diabetic mice. Conclusions/interpretation Diabetes aggravates acute pancreatitis and suppresses regeneration of the exocrine tissue. Thus, diabetes is not just a concomitant phenomenon of pancreatitis, but can have a fundamental influence on the progression of acute pancreatitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diabetes aggravates acute pancreatitis and inhibits pancreas regeneration in mice

et al. 2012

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“…This observation is similar to a study by Poddar et al ., where DM was documented only in CP . On the contrary, in a study on childhood pancreatitis (AP, ARP, and CP), 4.5% (eight of 176) of patients developed DM (seven in AP, one in ARP, and none in CP) . In a recent meta‐analysis of 24 prospective studies involving AP in adult patients, 37% developed either prediabetes or DM.…”

Section: Discussionmentioning

confidence: 97%

Incomplete functional and morphological recovery after acute and acute recurrent pancreatitis in children

Kadyada

Thapa

Kaushal

et al. 2018

J of Gastro and Hepatol

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“…Of note, 70% of the patients who developed DM as a result of pancreatitis required permanent insulin therapy . Despite this statistics, there are reports that suggest a more transient nature of the hyperglycemia . This complicates the diagnosis at autopsy as it cannot be known whether the hyperglycemia detected postmortem would have persisted in the absence of insulin therapy had the decedent survived.…”

Section: Discussionmentioning

confidence: 99%

The Interplay Between Diabetes and Pancreatitis: Two Case Reports of Sudden, Natural Deaths and a Review of the Literature

Butler

Emanuel

Self

et al. 2016

Journal of Forensic Sciences

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Diabetes mellitus (DM) is a common disease involving insulin resistance or deficit that, when left unchecked, may cause severe hyperglycemia and subsequent end-organ damage. Acute pancreatitis (AP) is inflammation of the pancreas that can lead to significant morbidity and mortality. AP and DM both account for a significant amount of sudden deaths, and rarely both disease processes may be present in the same decedent, causing some difficulty in wording the cause of death statement. Although much research has been directed at studying the causes and risk factors for AP and DM, there is a complex interplay between these diseases that is not fully understood. This study presents two autopsy cases of sudden, natural deaths that illustrate this interplay, along with a review of the literature. An algorithm for differentiating AP and DM is then discussed in the context of the presented cases as a proposed aid for forensic pathologists in the certification of such deaths.

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Hyperglycemia and Diabetes Mellitus in Children with Pancreatitis

Cited by 18 publications

References 27 publications

Diabetes aggravates acute pancreatitis and inhibits pancreas regeneration in mice

Diabetes aggravates acute pancreatitis and inhibits pancreas regeneration in mice

Incomplete functional and morphological recovery after acute and acute recurrent pancreatitis in children

The Interplay Between Diabetes and Pancreatitis: Two Case Reports of Sudden, Natural Deaths and a Review of the Literature

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