Incidence and Risk Factors for New-Onset Diabetes Mellitus After Surgical Resection of Pancreatic Cystic Lesions: A MarketScan Study. Issue 5 (19th May 2022)

• Record Type: Journal Article
• Authors: Firkins, Stephen A.; Hart, Phil A.; Porter, Kyle; Chiang, ChienWei; Cloyd, Jordan M.; Dillhoff, Mary; Lara, Luis F.; Manilchuk, Andrei; Papachristou, Georgios I.; Pawlik, Timothy M.; Tsung, Allan; Conwell, Darwin L.; Krishna, Somashekar G.
• Is Part Of: Pancreas. Volume 51:Issue 5(2022)
• Page Start: 427
• Page End: 434
• Publication Date: 2022-05-19
• Subjects: pancreatic cystic lesion -- pancreatectomy -- diabetes mellitus -- population database -- intraductal papillary mucinous neoplasm -- ADA - American Diabetes Association -- aHR - adjusted hazard ratio -- AP - acute pancreatitis -- ASGE - American Society for Gastrointestinal Endoscopy -- CI - confidence interval -- CPT - Current Procedural Terminology -- DM - diabetes mellitus -- DP - distal pancreatectomy -- GIP - gastric inhibitor peptide -- GLP - glucagon-like peptide -- HR - hazard ratio -- ICD-9-CM - International Classification of Diseases, Ninth Edition Clinical Modification -- ICD-10-CM - International Classification of Diseases, Tenth Edition Clinical Modification -- NODM - new-onset diabetes mellitus -- PCL - pancreatic cystic lesion -- PD - pancreaticoduodenectomy; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000002054
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objectives: There is a paucity of literature evaluating new-onset diabetes mellitus (NODM) after resection of pancreatic cystic lesions (PCLs). We sought to characterize the incidence and risk factors associated with NODM after partial pancreatectomy for PCLs. Methods: We utilized the IBM MarketScan Database (2012–2018) to identify all nondiabetic adults who underwent partial pancreatectomy for PCLs. Patients with any other pancreatic disease were excluded. We performed Kaplan-Meier analysis and multivariable Cox proportional hazards regression to define the incidence and risk factors of postoperative NODM. Results: Among 311 patients, the overall risk (95% confidence interval) of NODM was 9.1% (6.3–12.9%), 15.1% (11.3–20.2%), and 20.2% (15.3–26.4%) at 6, 12 and 24 months, respectively. Multivariable analysis (adjusted hazard ratio; 95% confidence interval) revealed that older age (1.97; 1.04–3.72; 55–64 vs 18–54 years), obesity (2.63; 1.35–5.12), hypertension (1.79; 1.01–3.17), and cardiovascular disease (2.54; 1.02–6.28) were independent predictors of NODM. Rates of NODM were similar after distal pancreatectomy versus pancreaticoduodenectomy. Conclusions: Within 2 years, 1 in 5 patients without any other pancreatic disease will develop NODM after partial pancreatectomy for PCLs. Those with advanced age, metabolic syndrome features, and/or cardiovascular disease may benefit from preoperative counseling and intensive postoperative monitoring, education, and treatment for diabetes mellitus.