Increased risk of type 3c diabetes mellitus after acute pancreatitis warrants a personalized approach including diabetes screening. Issue 6 (14th December 2022)

• Record Type: Journal Article
• Authors: Walker, Alexander; O'Kelly, James; Graham, Catriona; Nowell, Sian; Kidd, Doug; Mole, Damian J
• Is Part Of: BJS open. Volume 6:Issue 6(2022)
• Publication Date: 2022-12-14
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjsopen/zrac148
• Languages: English
• ISSNs: 2474-9842

Abstract

Abstract: Background: Acute pancreatitis (AP) is a frequent cause of hospitalization with long-term health consequences, including type 3c diabetes mellitus (DM). The incidence and risk factors for new-onset morbidities after AP need to be clarified to inform a personalized medicine approach. Methods: Using a longitudinal electronic healthcare record-linkage analysis, all patients admitted to hospital in Scotland with a first episode of AP between 1 April 2009 and 31 March 2012 and followed for a minimum of 5 years after their index AP admission were identified. All new-onset morbidity with specific focus on type 3c DM were analysed and, using time-split multiple regression. Results: A total of 2047 patients were included. AP requiring critical care was followed by 2 years of heightened risk (HR 5.24) of developing type 3c DM, increased risk of new-onset cardiac disease (HR 1.61), and renal disease (HR 2.96). The additional risk conferred by critical care AP had a negative interaction with time, whereas additional risk associated with male sex and a non-gallstone aetiology was long lasting. Conclusion: Based on these findings, a personalized approach to include type 3c DM screening for a minimum of 2 years for individuals who required critical care when hospitalized with AP is recommended. Abstract : Increased risk of type 3c diabetes mellitus after acute pancreatitis warrants a personalized approach to follow-up that includes diabetes screening for 2 years.