The influence of cholecystectomy and recurrent biliary events on the risk of post-pancreatitis diabetes mellitus: a nationwide cohort study in patients with first attack of acute pancreatitis

Cho, Jaelim; Scragg, Robert; Petrov, Maxim S.

doi:10.1016/j.hpb.2020.10.010

Cited by 12 publications

(15 citation statements)

References 52 publications

(68 reference statements)

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“…Based on our current analysis, people with recurrent AP are at a significantly increased risk for developing PPDM in comparison with those free from repeated attacks of AP, consistent with previous findings from two population-based studies ( 33 ) ( 50 ). The difference might be ascribed to the pancreas volume variation.…”

Section: Discussionsupporting

confidence: 91%

Non-Alcoholic Fatty Liver Disease (NAFLD) Is an Independent Risk Factor for Developing New-Onset Diabetes After Acute Pancreatitis: A Multicenter Retrospective Cohort Study in Chinese Population

Zhang

Yang

et al. 2022

Front. Endocrinol.

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BackgroundNumerous studies validated frequent glucose dysfunction in patients with acute pancreatitis (AP). However, the prevalence of new-onset diabetes in individuals after a first episode of AP varies widely among previous studies. This study aims to determine the incidence of post-acute pancreatitis diabetes mellitus (PPDM-A) in Chinese people and further identify potential risk factors that influence diabetes development in patients with AP.MethodsThis was a multi-center retrospective cohort study including 6009 inpatients with a first attack of AP. A total of 1804 patients with AP without known endocrine pancreatic disorders or other pancreatic exocrine diseases were eligible for analysis. Data was collected from medical records by hospital information system and telephone follow-ups after discharge. The multiple logistic regression analysis was established to evaluate the potential influencing factors of PPDM-A.ResultsThe prevalence of newly diagnosed diabetes after a first episode of AP in China was 6.2%. Data showed that patients who developed PPDM-A were more likely to be younger (X2 = 6.329, P = 0.012), experienced longer hospital stays (X2 = 6.949, P = 0.008) and had a higher frequency of overweight or obesity (X2 = 11.559, P = 0.003) compared to those with normal glycemia. The frequency of stress hyperglycemia on admission (X2 = 53.815, P < 0.001), hyperlipidemia (X2 = 33.594, P < 0.001) and non-alcoholic fatty liver disease (NAFLD) (X2 = 36.335, P < 0.001) were significantly higher among individuals with PPDM-A compared with control group. Also, patients with PPDM-A were more likely to be hyperlipidemic AP (X2 = 16.304, P = 0.001) and show a higher degree of severity (X2 = 7.834, P = 0.020) and recurrence rate (X2 = 26.908, P < 0.001) of AP compared to those without diabetes. In addition, multiple logistic regression analysis indicated that stress hyperglycemia, hyperlipidemia, NAFLD and repeated attacks of AP were the independent influence factors for developing PPDM-A.ConclusionOur study first demonstrated the prevalence of secondary diabetes in Chinese patients after AP. The disorder of glucose metabolism in individuals with AP should be regularly evaluated in clinical practice. Further studies are needed to verify the relationship between liver and pancreas in keeping glucose homeostasis under AP condition.

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Section: Discussionsupporting

confidence: 91%

Non-Alcoholic Fatty Liver Disease (NAFLD) Is an Independent Risk Factor for Developing New-Onset Diabetes After Acute Pancreatitis: A Multicenter Retrospective Cohort Study in Chinese Population

Zhang

Yang

et al. 2022

Front. Endocrinol.

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“…Patients who had 2 or ≥ 3 recurrent biliary events prior to cholecystectomy were at a significantly increased risk of post-pancreatitis diabetes mellitus. The results of your study are in line with that study 19 . These data support the SAPE model describing the transition of AP towards CP.…”

Section: Discussionsupporting

confidence: 87%

“…In addition to the limitations noted above, our research has several highly important advantages: (1) it can be used easily in all hospitals, (2) no additional laboratory measurements or imaging techniques are necessary after ruling out CP with imaging to establish a diagnosis of ECP, and (3) it allows us to start clinical trials and encourage patients to implement lifestyle changes to prevent the development of CP from ECP. Our results adds to the accumulating body of morphological 14 and population-based 19 studies on this topic. Our study shows that three or more episodes of RAP with no pancreatic morphological alterations may be considered ECP.…”

Section: Discussionsupporting

confidence: 52%

Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model

Hegyi

Soós

Tóth

et al. 2021

Sci Rep

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Chronic pancreatitis (CP) is an end-stage disease with no specific therapy; therefore, an early diagnosis is of crucial importance. In this study, data from 1315 and 318 patients were analysed from acute pancreatitis (AP) and CP registries, respectively. The population from the AP registry was divided into AP (n = 983), recurrent AP (RAP, n = 270) and CP (n = 62) groups. The prevalence of CP in combination with AP, RAP2, RAP3, RAP4 and RAP5 + was 0%, 1%, 16%, 50% and 47%, respectively, suggesting that three or more episodes of AP is a strong risk factor for CP. Laboratory, imaging and clinical biomarkers highlighted that patients with RAP3 + do not show a significant difference between RAPs and CP. Data from CP registries showed 98% of patients had at least one AP and the average number of episodes was four. We mimicked the human RAPs in a mouse model and found that three or more episodes of AP cause early chronic-like morphological changes in the pancreas. We concluded that three or more attacks of AP with no morphological changes to the pancreas could be considered as early CP (ECP).The new diagnostic criteria for ECP allow the majority of CP patients to be diagnosed earlier. They can be used in hospitals with no additional costs in healthcare.

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“…The prevalence is still likely to be under-estimated and may be expected to rise with increasing awareness. Diabetes secondary to diseases of the exocrine pancreas (DEP) or ‘pancreatogenic’ diabetes constitutes 1.6%–1.8% of new-onset diabetes in adults in comparison with 1.1% for type1DM (T1DM) [ 8 ]. An overall incidence of 2.6–2.8 per 100,000 general population for PPDM has been reported in population-based studies from New Zealand and the United Kingdom [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Post-pancreatitis diabetes mellitus: insight on optimal management with nutrition and lifestyle approaches

et al. 2022

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Pancreatitis is the leading gastrointestinal cause of hospitalizations. There are multiple short- and long-term complications associated with pancreatitis. Post-pancreatitis diabetes mellitus (PPDM) is one of the less explored complications of pancreatitis. Nonetheless, it has attracted considerable attention during the last decade. PPDM is now the second most common cause of new-onset diabetes mellitus (DM) in adults after type II DM surpassing type 1 DM. However, there exists a knowledge gap amongst practitioners regarding diagnosis, complications, and management of PPDM. In this narrative, we aim to provide a brief review regarding risks, diagnosis and management of PPDM with a special focus on dietary and lifestyle management strategies. KEY MESSAGES Post-pancreatitis diabetes mellitus (PPDM) is now the second most common cause of new-onset diabetes mellitus (DM) in adults after type II DM surpassing type 1 DM. New-onset diabetes in patients with pancreatitis could also be an early marker of occult pancreatic malignancy. Management of PPDM is complex and requires a team-based approach including gastroenterologists, endocrinologists, primary care physicians, nutritionists, and behavioural health specialists.

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The influence of cholecystectomy and recurrent biliary events on the risk of post-pancreatitis diabetes mellitus: a nationwide cohort study in patients with first attack of acute pancreatitis

Cited by 12 publications

References 52 publications

Non-Alcoholic Fatty Liver Disease (NAFLD) Is an Independent Risk Factor for Developing New-Onset Diabetes After Acute Pancreatitis: A Multicenter Retrospective Cohort Study in Chinese Population

Non-Alcoholic Fatty Liver Disease (NAFLD) Is an Independent Risk Factor for Developing New-Onset Diabetes After Acute Pancreatitis: A Multicenter Retrospective Cohort Study in Chinese Population

Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model

Post-pancreatitis diabetes mellitus: insight on optimal management with nutrition and lifestyle approaches

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