Smoking, cirrhosis predictors of diabetes mellitus in patients with acute pancreatitis
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CHARLOTTE, N.C. — Local injury, toxin exposure and systemic disease were among the top contributors to development of diabetes mellitus in patients with acute pancreatitis, according to a researcher at the ACG Annual Scientific Meeting.
“Diabetes is becoming an increasingly recognized complication as a potential sequela to acute pancreatitis,” Aneesa R. Chowdhury, MD, an internal medicine resident at Los Angeles County + University of Southern California Medical Center, said. “Studies have demonstrated higher mortality, increased risk of pancreatic cancer and increased insulin requirements in this subset of patients relative to patients with type 2 diabetes. However, the exact mechanisms of pancreatitis-related diabetes are poorly understood.”
In an ongoing, prospective observational cohort study, Chowdhury and colleagues analyzed 723 patients (mean age, 43 years; 50% women; 80% Hispanic) without pre-existing diabetes who were hospitalized for acute pancreatitis. Researchers noted 84.4% of pancreatitis cases in this cohort were mild.
After at least 9 months of follow-up, researchers identified diabetes in 4.6% of patients. According to multivariate analysis, predictors for the development of subsequent diabetes after acute pancreatitis included moderate to severe pancreatitis (OR = 2.94; 95% CI, 1.34-6.42), a history of smoking (OR = 2.17; 95% CI, 1.02-4.63) and cirrhosis (OR = 3.23; 95% CI, 1.02-4.53). Pancreatitis etiology was not a significant predictor for diabetes.
“Our study suggests that a combination of local injury, toxin exposure and systemic disease may contribute to the endocrine dysfunction acute pancreatitis patients can develop,” Chowdhury concluded. “Recognizing these factors may help clinicians identify at-risk patients for earlier intervention."
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Chowdhury AR, et al. Abstract S5: Predictors of diabetes mellitus following admission for acute pancreatitis: Analysis from a prospective observational cohort. Presented at: ACG Annual Scientific Meeting; Oct. 21-26, 2022; Charlotte, N.C. (hybrid meeting).
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