ECE2014 Poster Presentations Diabetes (epidemiology, pathophysiology) (63 abstracts)
Objective: We longitudinally assessed the overall and age- and sex-specific incidence rates and relative risks of newly diagnosed diabetes mellitus in patients surviving the first-attack acute pancreatitis (AP) as compared to matched controls.
Methods: Study cohort included 2966 AP patients and 11 864 non-AP controls individually matched on age, sex and date of index admission, with an AP/non-AP ratio of 1:4. Incidence rate was estimated under Poisson assumption; and relative risks of diabetes were indicated by hazard ratio estimated from Cox proportional hazard regression models.
Results: The incidence of diabetes was 49.7 and 21.1 per 1000 person-years for AP and control groups, respectively; representing a covariate-adjusted hazard ratio (HR) of 2.06 (95% CI 1.852.30). The risk of diabetes was greater in men than in women (HR 2.46 vs 1.42) and in patients with severe AP than in those with mild AP (HR 2.40 vs 1.99). In men, the risk was the most increased in young adults aged <45 years with severe AP (HR 5.29), whereas in women, the effect of age was less obvious. For older people (≧65 years), the risk was non-significant, regardless of sex and AP severity. Moreover, mild AP was also significantly associated with increased risk of developing insulin-dependent diabetes (HR 5.05, 95% CI 1.7514.55). The exclusion of patients with subsequent recurrence of AP only slightly reduced the HRs, but did not change the results.
Conclusions: The risk of diabetes doubles after AP, indicating a need of long-term screening for diabetes after the first attack regardless of the severity. Future research is needed to further define high risk patients, to find the most cost-effective follow-up strategy, and to elucidate the underlying mechanisms of the relation.