Risk factors for diabetes mellitus in chronic pancreatitis

Malka, David; Hammel, Pascal; Sauvanet, Alain; Rufat, Pierre; O’Toole, Dermot; Bardet, Pascal; Belghiti, Jacques; Bernadès, P; Ruszniewski, Philippe; Lévy, Philippe

doi:10.1053/gast.2000.19286

Cited by 283 publications

(203 citation statements)

References 46 publications

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“…Our study is consistent with previous studies in risk factors such as alcoholism 3,4 and distal pancreatectomy. 3 Nevertheless, with recruitment of 2011 patients (4.5 times in number of our previous study in 2011 17 ) and much longer duration of follow-up (22.0 vs 7.3 years in 2011), our study identified 3 new risk factors for DM: male sex, steatorrhea, and biliary stricture.…”

Section: Discussionsupporting

confidence: 93%

“…[3][4][5][6][7][8] In the present study, 28% of patients with CP developed DM, which is comparable with previous studies. Our study is consistent with previous studies in risk factors such as alcoholism 3,4 and distal pancreatectomy.…”

Section: Discussionsupporting

confidence: 91%

“…20 In the present study on DM development in CP patients, the following patients were further excluded: those with a family history of insulin-dependent DM in first-/second-/third-degree relatives and those whose insulin-dependent DM was diagnosed over 2 years before the onset of CP. 3,17 The study was approved by the Ethics Committee of Changhai Hospital, Second Military Medical University, Shanghai, China, according to the Helsinki Declaration. Written informed consent was obtained from all participating patients.…”

Section: Patients and Databasementioning

confidence: 99%

“…1,2 Decrease in beta cells and insulin resistance contributes to diabetes mellitus (DM), which accounts for 26% to 41% in the natural course of CP. [3][4][5][6][7][8] The micro-or macrovascular damage secondary to DM is a major threat for CP patients, increasing the mortality. 9,10 Referred to as brittle diabetes, DM secondary to CP (type 3c DM) is characterized by frequent episodes of hypoglycemia, which is difficult to control and affects quality of life of patients with CP.…”

Section: Introductionmentioning

confidence: 99%

“…11,13 Several studies have confirmed alcoholism and distal pancreatectomy as independent risk factors for DM development in CP patients. 3,4 Studies also showed that type 3c DM may share common risk factors with type 1 and type 2 DM. 11 The identification of risk factors may contribute to risk stratification of CP patients, therefore providing better guidance on screening interval for DM monitoring, and evidence for lifestyle modifications and therapy selection.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Risk factors for diabetes mellitus in chronic pancreatitis: A cohort of 2,011 patients

Xin

2016

Pancreatology

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

Section: Patients and Databasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk factors for diabetes mellitus in chronic pancreatitis: A cohort of 2,011 patients

Xin

2016

Pancreatology

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Diagnosis and Management of Chronic Pancreatitis

Singh

Yadav

Garg

2019

JAMA

279

188

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hronic pancreatitis (CP) is a chronic progressive disease with an annual incidence of 5 to 8 and prevalence of 42 to 73 cases per 100 000 adults in the United States. 1-3 Prevalence rates varying from 36 to 125 per 100 000 population have been reported from Japan, China, and India, of which India has the highest prevalence. 4,5 Chronic pancreatitis is characterized by fibrosis and inflammation of the pancreas in individuals with genetic, environmental, and other risk factors such as hypertriglyceridemia. Chronic pancreatitis is characterized by pancreatic atrophy, fibrosis, ductal strictures and distortion, calcifications, dysplasia, exocrine insufficiency and diabetes, and chronic pain. 6 This review summarizes current evidence regarding risk factors, pathophysiology, clinical features, diagnostic evaluation, treatment, and prognosis of CP. MethodsWe searched PubMed for relevant English-language articles published from January 1, 2000, to July 1, 2019. Search terms included chronic pancreatitis and each of the following:

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Diabetes Secondary to Acquired Disease to the Pancreas

Prato¹,

Coppelli²,

Tiengo³

2004

International Textbook of Diabetes Mellitus

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Secondary diabetes is a condition of hyperglycemia which develops after the destruction of the pancreatic tissue by an acquired disease with subsequent impairment of exocrine and endocrine pancreatic functions. In general, any pathologic process of the pancreatic acinar tissue may results in an insult to its endocrine component, leading to some degree of hormone insufficiency. This condition was first described in 1788 by Sir Thomas Cawley, but it was soon appreciated that hyperglycemia can ensues acute and chronic pancreatitis, partial and total pancreatectomy, neoplasia as well as systemic processes involving the pancreas, such as hemochromatosis and cystic fibrosis. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus of the American Diabetes Association has identified these forms of diabetes as “diabetes secondary to diseases of the exocrine pancreas.” The new diagnostic criteria for diabetes introduced by the ADA and WHO Expert Committees are likely to influence the prevalence of diabetes in patients with diseases of the exocrine pancreas, but direct assessment using the new criteria is still too scanty. When the 1979 NDDG and 1985 WHO criteria are used, it can be calculated that diabetes secondary to disease of the exocrine pancreas represents, approximately, 0.5% of all cases of diabetes mellitus. Its frequency is likely to be twice as high in populations with heavy alcohol consumption. In the tropics, the prevalence of diabetes secondary to fibrocalculous pancreatitis can be as high as 10–20%. At variance with the selective B‐cell destruction occurring in type 1 diabetes, pancreatic diabetes is characterized by concomitant destruction of all endocrine cells of the islet of Langherans. The dual insulin–glucagon deficit is responsible for many of the metabolic and clinical manifestation of this form of diabetes, including lower risk for ketoacidosis and more frequent and severe hypoglycemic episodes. Since the late 1950s, the general idea has been that secondary diabetes was not associated with vascular complications. However, with the improved life expectancy of these patients during the past few years, a similar prevalence of retinopathy and microalbuminuria has been described in pancreatic and type 1 diabetes mellitus. The knowledge of the hormonal, metabolic, and clinical features of these forms of diabetes is essential in defining the most appropriate therapeutic strategies.

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Risk factors for diabetes mellitus in chronic pancreatitis

Cited by 283 publications

References 46 publications

Risk factors for diabetes mellitus in chronic pancreatitis: A cohort of 2,011 patients

Risk factors for diabetes mellitus in chronic pancreatitis: A cohort of 2,011 patients

Diagnosis and Management of Chronic Pancreatitis

Diabetes Secondary to Acquired Disease to the Pancreas

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