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Childhood acute pancreatitis may increase risk for diabetes in young adulthood
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Children who experienced a single episode of acute pancreatitis may have an increased risk for developing type 2 diabetes before age 40 years, according to findings published in Diabetes Care.
“A clinically resolved single event of acute pancreatitis is associated with an increased risk for diabetes at young adulthood, independent of adolescent obesity or sociodemographic factors, and is associated with a younger age of disease diagnosis,” Gilad Twig, MD, PhD, of the Israel Defense Forces Medical Corps in Ramat Gan, Israel, and colleagues wrote. “These patients therefore may require a tighter follow-up and aggressive control of other diabetes risk factors.”
Twig and colleagues used data from military service evaluations of 1,802,110 adolescents from 1979 to 2008 to identify instances of acute pancreatitis throughout childhood and adolescence. The researchers then used data through 2016 from the Israeli National Diabetes Registry to identify cases of diabetes in the cohort.
The researchers found that one case of acute pancreatitis that later resolved occurred in 0.016% of the study population (n = 281; mean age, 17.5 years; 30.6% girls). The researchers also found more than one case of acute pancreatitis occurred in 0.006% of the study population, but limited their primary analysis to those with just one case.
“Our classification of resolved acute pancreatitis was strict in limiting the history to no more than a single event and assuring a minimum disease-free period of at least 3 years, making genetic factors or hypertriglyceridemia as less likely etiologies in our cohort,” the researchers wrote.
Among the pancreatitis group, 4.63% later developed diabetes — no cases were type 1 diabetes, according to the researchers — vs. 2.47% of those without pancreatitis. The odds for developing diabetes were doubled for those who had pancreatitis vs. those with no cases based on fully adjusted models (adjusted OR = 2.1; 95% CI, 1.15-3.84).
It took an average of 18.7 years before diabetes occurred in those with one case of acute pancreatitis and an average of 23.2 years before diabetes occurred in those with no cases (P = .029). The average age of diabetes diagnosis was 36.4 years among the pancreatitis group vs. 40.7 years for those without pancreatitis (P = .037). In addition, 92% of the pancreatitis group who developed diabetes was diagnoses before age 40 years vs. 47% of those without pancreatitis (P = .002).
“Future studies are required to confirm these results in other populations and test the role of early therapeutic intervention at the prediabetes stage to prevent or delay diabetes onset,” the researchers wrote. – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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