Diabetes in chronic pancreatitis: risk factors and natural history.

Published on Jun 1, 2021in Current Opinion in Gastroenterology3.225
· DOI :10.1097/MOG.0000000000000756
Mark O. Goodarzi (NIH: National Institutes of Health), Maxim S. Petrov28
Estimated H-index: 28
+ 1 AuthorsPhil A. Hart29
Estimated H-index: 29
Sources
Abstract
PURPOSE OF REVIEW The purpose of this review is to delineate risk factors for the development of diabetes in patients with chronic pancreatitis. The natural history including progression to diabetes and complications that develop once diabetes occurs in chronic pancreatitis is also reviewed. RECENT FINDINGS Studies have found that predictors of diabetes in chronic pancreatitis include both risk factors for type 2 diabetes (e.g., obesity, genetic variants) as well as pancreas-specific factors (e.g., pancreatic calcification, exocrine insufficiency). Rates of diabetes in chronic pancreatitis are strongly related to the duration of chronic pancreatitis, reflecting progressive dysfunction and damage to the insulin-secreting beta cells. Patients with diabetes and chronic pancreatitis experience an excess burden of complications, including higher all-cause and cancer-related mortality. SUMMARY The high incidence and significant impact of diabetes on the morbidity and mortality of patients with chronic pancreatitis highlights the urgent need for clinically applicable models to predict diabetes in those with chronic pancreatitis, allowing efforts for targeted interventions to prevent diabetes. Research being carried out in the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer holds promise to fulfill these goals.
📖 Papers frequently viewed together
38 Citations
1999
6 Authors (Cavallini G, ..., Bruna Vaona)
References0
Newest
#1Satish Munigala (SLU: Saint Louis University)H-Index: 16
#2Divya S. Subramaniam (SLU: Saint Louis University)H-Index: 4
Last. Sunil A Sheth (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 32
view all 6 authors...
BACKGROUND Chronic pancreatitis (CP) is a risk factor for pancreatic ductal adenocarcinoma (PDAC); nevertheless, the true incidence of PDAC in CP patients in the United States remains unclear. AIMS We evaluated the risk of developing PDAC two or more years after a new diagnosis of CP. METHODS Retrospective study of veterans from September 1999 to October 2015. A three-year washout period was applied to exclude patients with preexisting CP and PDAC. PDAC risk was evaluated in patients with new-di...
Source
#1Jaelim Cho (University of Auckland)H-Index: 15
#1Jaelim Cho (University of Auckland)H-Index: 3
Last. Maxim S. Petrov (University of Auckland)H-Index: 28
view all 3 authors...
Aims The aim was to investigate sex- and age-stratified risks of cause-specific death and life expectancy in individuals with post-pancreatitis diabetes mellitus (PPDM). Methods Nationwide data on mortality in New Zealand were obtained. For two head-to-head comparisons (PPDM versus type 2 diabetes mellitus [T2DM]; PPDM versus type 1 diabetes mellitus [T1DM]), the groups were matched on age, sex, and calendar year of diabetes diagnosis. Multivariable Cox regression analyses were conducted to esti...
2 CitationsSource
#1Mohsin AslamH-Index: 4
#2Nitin JagtapH-Index: 5
Last. D. Nageshwar ReddyH-Index: 32
view all 5 authors...
Abstract Endocrine insufficiency is a common and frequent complication of chronic pancreatitis. Identifying the role of pancreatic damage in the development of diabetes is important for early identification and appropriate management. Methods All consecutive CP patients between January 2019 and May 2020 were retrospectively studied. Relevant statistical tests were performed. A two sided p value Results Total 587 chronic pancreatitis patients were included of which 118 (20.1%) patients developed ...
1 CitationsSource
#1Jaelim Cho (University of Auckland)H-Index: 3
#1Jaelim Cho (University of Auckland)H-Index: 15
Last. Maxim S. Petrov (University of Auckland)H-Index: 28
view all 3 authors...
OBJECTIVE Pancreatitis and diabetes are established risk factors for pancreatic cancer. However, to date, studies have investigated only the risk associated with either of them alone. The aim of this study was to investigate the effect of pancreatitis and diabetes combined, as well as their temporal relationship, on the risk of pancreatic cancer. RESEARCH DESIGN AND METHODS Nationwide cancer registry was linked to hospital discharge and mortality data from 1998 to 2015 in New Zealand. Incidence ...
11 CitationsSource
#1Yu Liu ('SMMU': Second Military Medical University)H-Index: 4
#2Dan Wang ('SMMU': Second Military Medical University)H-Index: 12
Last. Liang-Hao Hu ('SMMU': Second Military Medical University)H-Index: 17
view all 25 authors...
BACKGROUND AND AIM: Diabetes mellitus (DM) is a common complication of idiopathic chronic pancreatitis (ICP), which impairs the quality of life for patients. This study aimed to identify risk factors and develop nomogram for DM in ICP to help early diagnosis. METHODS: Idiopathic chronic pancreatitis patients admitted to our center from January 2000 to December 2013 were included. Cumulative rates of DM were calculated by Kaplan-Meier method. Patients were randomly assigned, in a 2:1 ratio, to th...
5 CitationsSource
#1Søren Schou Olesen (AAU: Aalborg University)H-Index: 28
#2Jakob Lykke Poulsen (AAU: Aalborg University)H-Index: 15
Last. Asbjørn Mohr Drewes (AAU: Aalborg University)H-Index: 78
view all 19 authors...
BackgroundDiabetes mellitus is a common complication of chronic pancreatitis. It is traditionally considered to develop as a consequence of beta cell loss, but there might be additional factors. Re...
5 CitationsSource
#1Barite W. Gutama (UMN: University of Minnesota)H-Index: 1
#2Yi Yang (UMN: University of Minnesota)H-Index: 3
Last. Melena D. BellinH-Index: 41
view all 12 authors...
OBJECTIVE: Little data exist describing the change over time in islet function and glycemic control in patients with chronic pancreatitis (CP). METHODS: In 325 CP patients who underwent 2 mixed meal tolerance tests and/or glycated hemoglobin (HbA1c) levels, we estimated the rate of change in metabolic measures per 6 months and assessed the association between potential risk factors for diabetes and rate of change using multivariate regression models. RESULTS: Per 6-month time, HbA1c increased by...
1 CitationsSource
#1Jaelim Cho (University of Auckland)H-Index: 15
#1Jaelim Cho (University of Auckland)H-Index: 3
Last. Maxim S. Petrov (University of Auckland)H-Index: 28
view all 5 authors...
OBJECTIVE There are no specific treatment guidelines for diabetes of the exocrine pancreas. High-quality studies are warranted to investigate whether the use of antidiabetic medications has survival benefit in individuals with diabetes of the exocrine pancreas. The objective was to determine the risk of mortality associated with the use of antidiabetic medications in individuals with pancreatic cancer–related diabetes (PCRD) and postpancreatitis diabetes mellitus (PPDM). RESEARCH DESIGN AND METH...
28 CitationsSource
#1Xiangyun ZhuH-Index: 5
#1Xiangyun ZhuH-Index: 2
Last. Ling LiH-Index: 2
view all 11 authors...
OBJECTIVES: The aim of this study was to assess the occurrence of new-onset diabetes mellitus (DM) after chronic pancreatitis (CP) diagnosis via systematic review and meta-analysis. METHODS: A systematic review of literature and meta-analysis of relevant reports were performed. The primary outcome measures studied were newly diagnosed DM and DM treated with insulin. For the binary outcomes, pooled prevalence and 95% confidence interval (CI) were calculated. METHODS: Fifteen studies involving 897...
5 CitationsSource
#1Mark O. Goodarzi (Cedars-Sinai Medical Center)H-Index: 67
#2Tanvi Nagpal (University of Pittsburgh)H-Index: 1
Last. David C. WhitcombH-Index: 89
view all 36 authors...
Introduction:Diabetes mellitus (DM) is a complication of chronic pancreatitis (CP). Whether pancreatogenic diabetes associated with CP-DM represents a discrete pathophysiologic entity from type 2 DM (T2DM) remains uncertain. Addressing this question is needed for development of specific measures to
16 CitationsSource
Cited By0
Newest