Clinical and biochemical characteristics of postpancreatitis diabetes mellitus: A cross‐sectional study from the Danish nationwide DD2 cohort. Issue 12 (21st July 2021)

• Record Type: Journal Article
• Authors: Olesen, Søren Schou; Svane, Helene Matilde Lundsgaard; Nicolaisen, Sia Kromann; Kristensen, Jette Kolding; Drewes, Asbjørn Mohr; Brandslund, Ivan; Beck‐Nielsen, Henning; Nielsen, Jens Steen; Thomsen, Reimar Wernich
• Is Part Of: Journal of diabetes. Volume 13:Issue 12(2021)
• Page Start: 960
• Page End: 974
• Publication Date: 2021-07-21
• Subjects: beta‐cell function -- glucose homeostasis -- insulin resistance -- plasma amylase -- prevalence; 细胞功能 -- 葡萄糖稳态 -- 胰岛素抵抗 -- 血浆淀粉酶 -- 患病率; Diabetes -- Periodicals; 618.3646005
• DOI: 10.1111/1753-0407.13210
• Languages: English
• ISSNs: 1753-0393

Abstract

Abstract: Background: Postpancreatitis diabetes mellitus (PPDM) is a common metabolic sequalae of acute and chronic pancreatitis. We conducted a cross‐sectional study to examine the proportion of PPDM among patients clinically diagnosed with type 2 diabetes (T2D) in Denmark and their clinical and biochemical characteristics. Methods: We identified all past diagnoses of pancreatitis among patients in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort through linkage with national health registries. Using International Classification of Diseases, Tenth Revision codes we categorized patients as PPDM and further divided them into acute/chronic subtypes (PPDM‐A and PPDM‐C). We assessed PPDM prevalence and examined associations with clinical and biochemical parameters using log binomial or Poisson regression to calculate age‐/sex‐adjusted prevalence ratios (aPRs). Results: Among 5564 patients with a clinical diagnosis of T2D, 78 (1.4%) had PPDM. Compared to T2D, PPDM patients were more often underweight or normal weight (body mass index ≤25.0 kg/m 2 : aPR 2.3; 95% confidence interval [CI]: 1.6‐3.2) and had lower waist‐to‐hip ratio (≤0.95/≤0.80 in men/women: aPRs 1.8; 95% CI: 1.2‐2.7). PPDM patients had lower plasma amylase levels (<17 U/L: aPRs 2.2; 95% CI: 1.1‐4.3), higher insulin sensitivity (homeostatic model assessment 2S [HOMA2S] >63: aPR 2.0; 95% CI: 1.2‐3.2) and tended to have worse glycaemic control (HbA1c ≥8.0%: aPRs 1.4; 95% CI: 0.8‐2.4). PPDM‐A was largely indistinguishable from T2D, whereas PPDM‐C had impaired insulin secretion, higher insulin sensitivity, and worse glycemic control. Conclusions: The proportion of PPDM among patients with clinically diagnosed T2D is ~1.5% in an everyday clinical care setting. Glucose metabolism of PPDM‐A is largely indistinguishable from T2D, whereas PPDM‐C differs in relation to insulin secretion and sensitivity. Abstract : Highlights Among patients with clinically diagnosed type 2 diabetes, the proportion of postpancreatitis diabetes mellitus (PPDM) is ~1.5% in an everyday clinical care setting. Glucose metabolism of PPDM folowing acute pancreatitis is largely indistinguishable from T2D, whereas PPDM associated with chronic pancreatitis differs in relation to insulin secretion, insulin sensitivity, and glycemic control. 摘要: 背景: 胰腺炎后糖尿病(PPDM)是急性和慢性胰腺炎常见的代谢后遗症。我们进行了一项横断面研究, 以检查在丹麦临床诊断为2型糖尿病患者中 PPDM 的比例及其临床和生化特征。 方法: 在丹麦2型糖尿病战略研究中心(DD2), 通过与国家健康登记处的联系, 确定了所有过去诊断的胰腺炎患者。根据第十次国际疾病与相关健康问题统计分类修订代码, 将PPDM患者进一步分为急性/慢性亚型(PPDM‐a 和 PPDM‐c)。评估PPDM患病率, 使用对数二项式或对数泊松回归计算年龄/性别调整患病率(aPR), 检查与临床和生化参数的相关性。 结果: 5564例临床诊断为T2D 的患者中, 78例(1.4%)患有 PPDM。与T2D相比, PPDM患者体重偏轻或正常(体重指数≤25.0 kg/m 2 : aPR 2.3; 95% 置信区间[ CI] : 1.6‐3.2), 腰臀比较低(男/女≤0.95/≤0.80: aPR 1.8; 95% CI: 1.2‐2.7)。PPDM患者血浆淀粉酶水平较低(< 17U/L: aPRs 2.2; 95% CI: 1.1‐4.3), 胰岛素敏感性较高(稳态模型评估2S [ HOMA2S ] > 63: aPR 2.0; 95% CI: 1.2‐3.2), 血糖控制较差(HbA1c ≥8.0% : aPRs 1.4; 95% CI: 0.8‐2.4)。PPDM‐A 与 T2D 在很大程度上没有区别, 而 PPDM‐C胰岛素分泌减弱, 胰岛素敏感性增强, 血糖控制较差。 结论: 在日常临床护理环境中, 临诊断为 T2D 的患者中 PPDM 的比例约为1.5% 。PPDM‐A 的葡萄糖代谢与 T2D很难区分, 而 PPDM‐C 在胰岛素分泌和敏感性的方面有所不同。