ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P884 | DOI: 10.1530/endoabs.63.P884

Development of diabetes after pancreatic resection

José Ignacio Martínez Montoro, María Molina Vega, Ana María Gómez Pérez, Yolanda Eslava Cea, José Manuel García Almeida, Miguel Ángel Suárez Muñoz & Francisco José Tinahones Madueño

Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain.

Introduction: The development of diabetes is common after pancreatic surgery, so a close follow-up is essential in order to make an early diagnosis and start treatment as soon as possible.

Material and methods: Data from 56 patients subjected to pancreatic surgery between 2013 and 2018 are presented. Demographic and clinical-analytical characteristics are also described. We analyzed the incidence of diabetes during the follow-up (one month after surgery [PO], 3–6 months after surgery [M2] and one year after surgery [M3]) in those patients without previous diabetes and compared characteristics between those who developed diabetes and those who did not. Regarding the different surgical techniques: cephalic duodeno-pancreatectomy (CDP) with pancreatico-jejunal anastomosis (CDP-PJ), CDP with pancreatico-gastric anastomosis (CDP-PG), Distal pancreatectomy with splenectomy (DP) and total pancreatectomy (TP). Patients subjected to TP were excluded from the analyses, as it necessarily produces diabetes.

Results: We collected data from 56 patients, 64.6±8.6 years old, 59.6% males. 28.8% with previous diabetes. Type of surgery: 34.6% CPD-PJ, 25% CPD-PG, 15.4% TP, 25% DP. Pathological anatomy: 73.1% adenocarcinoma, 7.7% neuroendocrine tumor, 19.2% others. Cumulative incidence of diabetes was 50% (68.7%[PO], 18.75%[M2], 12.5%[M3]). Comparative characteristics between both groups are shown in Table 1. We see that those who developed diabetes were older than those who did not. To analyze the factors related to the development of diabetes, we grouped the patients by the surgical technique they were subjected: CPD and DP. In the logistic regression analysis (using as dependent variable the development of diabetes after surgery), although the age is close to the statistical significance, we did not find any factor which was independently associated with the development of diabetes: age (OR 1.136; CI 95% 0.995–1.303, P 0.059), sex (OR 0.869; CI 95% 0.151–4.994, P 0.875), type of surgery (OR 2.227; CI 95% 0.290–17.118, P 0.442).

Table 1
Development of diabetesNon-development of diabetesP
Age (years)64.8±7.258.4±6.10.029
BMI (kg/m2)26.5±3.125±2.80.229
Sex (%)0.662
Diagnosis (%)0.095
Neuroendocrine tumor18.80
Pluripathology (%)0.887
Type of surgery (%)0.129

Conclusions: A high percentage of patients with pancreatic resection developed diabetes. The development of diabetes was more common in the first month after surgery. Age seems to increase the likelihood of developing diabetes after pancreatic resection.

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