Increased Risk of Acute Pancreatitis and Biliary Disease Observed in Patients With Type 2 Diabetes

Abstract

OBJECTIVE -The objective of this study was to assess the risk of acute pancreatitis in patients with type 2 diabetes compared with that in patients without diabetes. We also examined the risk of biliary disease (defined as occurrence of cholelithiasis, acute cholecystitis, or cholecystectomy), which is a major cause of pancreatitis.RESEARCH DESIGN AND METHODS -We conducted a retrospective cohort study using a large, geographically diverse U.S. health care claims database. Eligible patients (Ն18 years) were enrolled for at least 12 continuous months (1999 -2005), with no incident events of pancreatitis or biliary disease during that 1 year baseline period. ICD-9 codes and prescription data were used to identify patients with type 2 diabetes; ICD-9 codes were also used to identify cases of pancreatitis and biliary disease. Overall, 337,067 patients with type 2 diabetes were matched on age and sex with 337,067 patients without diabetes. Incidence rates of disease and 95% CI were calculated per 100,000 person-years of exposure.RESULTS -The type 2 diabetic cohort had a 2.83-fold (95% CI 2.61-3.06) greater risk of pancreatitis and 1.91-fold (1.84 -1.99) greater risk of biliary disease compared with the nondiabetic cohort. Relative to patients of corresponding age without diabetes, younger type 2 diabetic patients had the highest risk of pancreatitis (Ͻ45 years: incidence rate ratio [IRR] CONCLUSIONS -These data suggest that patients with type 2 diabetes may have an increased risk of acute pancreatitis and biliary disease.

Declining Cholecystectomy Rate During the Era of Statin Use in Finland: A Population-Based Cohort Study Between 1995 and 2009

“…A worldwide increase in aging of general population, metabolic syndrome, obesity, and diabetes mellitus is likely to cause an elevated risk of symptomatic biliary stone disease and subsequent requirement for the LC (7)(8)(9). As in other Western countries, obesity and closely associated type 2 diabetes are rapidly increasing in Finland (10,11).…”

Incidence of Pancreatitis and Pancreatic Cancer in a Randomized Controlled Multicenter Trial (SAVOR-TIMI 53) of the Dipeptidyl Peptidase-4 Inhibitor Saxagliptin

“…Several clinical features associated with type 2 diabetes and obesity are recognized risk factors for acute pancreatitis (1). Recently, concerns have been raised regarding long-term consequences of incretin therapy in type 2 diabetic patients.…”

Acute pancreatitis and Type 2 Diabetes Mellitus; who is guilty?

“…Two large studies reported that patients with type 2 DM have 1.49-2.83 fold increased risk of acute pancreatitis compared to nondiabetics [2,3]. The exact cause of the increased risk of pancreatitis in diabetic patients is unclear, however, the known risk factors for pancreatitis appear more frequently in diabetic patients.…”

“…Other etiologic factors are biliary sludge and microlithiasis, smoking, hypertriglyceridemia, hypercalcemia, drugs, obesity, diabetes, infections and toxins, trauma, pancreas divisum, vascular disease, pregnancy and idiopathic [1]. Patients with diabetes mellitus have a 2 fold increase in the risk of pancreatitis due to factors such as obesity, gallstones, elevated triglycerides, and medications [2,3]. Obesity increases risk of pancreatitis and pancreas carcinoma due to increased inflammation [4].…”