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News

Newly diagnosed diabetes mellitus after acute pancreatitis

Patients with acute pancreatitis often develop prediabetes and/or DM after discharge from hospital, reports the latest issue of Gut.

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Diabetes mellitus (DM) is common in the general population and it poses a heavy burden to society in the form of long-term disability, healthcare use and costs.

The pancreas is a key player in glucose homeostasis, but the occurrence of newly diagnosed DM after acute pancreatitis, the most frequent disease of the pancreas, has never been assessed systematically.

Dr Maxim Petrov and colleagues from New Zealand conducted a systematic literature review to determine the prevalence and time course of DM, and related conditions after the first attack of acute pancreatitis as well as the impact of covariates.

Relevant literature cited in 3 electronic databases was reviewed independently by 2 authors.

The team's main outcome measures studied were newly diagnosed prediabetes, DM, or DM treated with insulin.

35% of patients receiving PEG had an Ottawa bowel preparation scale score ≤4
Gut

A total of 24 prospective clinical studies, involving 1102 patients with first episode of acute pancreatitis, met all the eligibility criteria.

The research team observed prediabetes and/or DM in 37% individuals after acute pancreatitis.

The pooled prevalence of prediabetes, DM and treatment with insulin after acute pancreatitis was 16%, 23%, and 15%, respectively.

The team noted that newly diagnosed DM developed in 15% of individuals within 12 months after first episode of acute pancreatitis, and the risk increased significantly at 5 years.

A similar trend was observed with regard to treatment with insulin.

The severity of acute pancreatitis, its etiology, individuals’ age and gender had minimal effect on the studied outcomes.

Dr Petrov's team commented, "Patients with acute pancreatitis often develop prediabetes and/or DM after discharge from hospital, and have a greater than 2-fold increased risk of DM over 5 years."

"Further studies are warranted to determine the optimal strategy for its detection and whether the risk of developing DM after acute pancreatitis can be reduced."

Gut 2014; 63: 818-831
17 April 2014

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