Patient and Disease Characteristics Associated With the Presence of Diabetes Mellitus in Adults With Chronic Pancreatitis in the United States
Year: 2017
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies. METHODS: Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers. Questionnaires were completed by patients and physicians in a cross-sectional assessment. Patient demographics and disease characteristics were compared for CP with DM vs. without DM. Logistic regression was performed to assess the variables associated with DM diagnosis in a multivariable model. RESULTS: Diabetics were more likely to be black (P=0.02), overweight, or obese (P<0.001), and with a family history of DM (P=0.0005). CP patients with DM were more likely to have pancreatic calcifications (63% vs. 54%, P=0.002), atrophy (44% vs. 32%, P<0.0001), and prior pancreas surgery (26.9% vs. 16.9%, P<0.0001). In multivariate logistic regression modeling, the strongest risk factors for DM were obesity (odds ratio (OR) 2.8, 95% confidence interval (CI) 1.9, 4.2) and exocrine insufficiency (OR 2.4, 95% CI 1.8, 3.2). CONCLUSIONS: In this large multicenter cohort of patients with CP, exocrine insufficiency, calcifications, and pancreas surgery conveyed higher odds of having DM. However, the traditional 'type 2 DM' risk factors of obesity and family history were similarly important in conveying risk for DM.
DOI: 10.1038/ajg.2017.181
Authors: Melena D Bellin, David C Whitcomb, Judah Abberbock, Stuart Sherman, Bimaljit S Sandhu, Timothy B Gardner, Michelle A Anderson, Michele D Lewis, Samer Alkaade, Vikesh K Singh, John Baillie, Peter A Banks, Darwin Conwell, Gregory A Cote, Nalini M Guda, Thiruvengadam Muniraj, Gong Tang, Randall E Brand, Andres Gelrud, Stephen T Amann, Christopher E Forsmark, C Mel Wilcox, Adam Slivka, Dhiraj Yadav
Institutions: University of Minnesota Medical Center, University of Pittsburgh Medical Center, University of Pittsburgh, Indiana University Indianapolis, Dartmouth–Hitchcock Medical Center, University of Michigan, Mayo Clinic, Mayo Clinic in Florida, Saint Louis University, Johns Hopkins University, Johns Hopkins Medicine, Virginia Commonwealth University, Brigham and Women's Hospital, The Ohio State University, Medical University of South Carolina, Aurora St. Luke's Medical Center, Yale University, University of Chicago, University of Florida, University of Alabama at Birmingham
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1454999011, G2351745370, G2434943017, The Ohio State University Chronic Pancreatitis Diabetes Pancreas Cancer (CPDPC) Clinical Center, University of Pittsburgh Clinical and Translational Science Institute, G424479090, G5162886386, G884570035, UPMC Clinical Center for the Study of Chronic Pancreatitis and Diabetes
OpenAlex ID: W2737570459