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Am J Gastroenterol. 2017 Sep;112(9):1457-1465. doi: 10.1038/ajg.2017.181. Epub 2017 Jul 25.

Patient and Disease Characteristics Associated With the Presence of Diabetes Mellitus in Adults With Chronic Pancreatitis in the United States.

Author information

1
Department of Pediatrics, University of Minnesota Medical Center and Masonic Children's Hospital, Minneapolis, Minnesota, USA.
2
Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
3
Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
4
Department of Medicine, Indiana University, Indianapolis, Indiana, USA.
5
Richmond Gastroenterology Associates, Richmond, Virginia, USA.
6
Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
7
University of Michigan, Ann Arbor, Michigan, USA.
8
Mayo Clinic, Jacksonville, Florida, USA.
9
Department of Internal Medicine, Saint Louis University, St Louis, Missouri, USA.
10
Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
11
Virginia Commonwealth University, Richmond, Virginia, USA.
12
Brigham and Women's Hospital, Boston, Massachusetts, USA.
13
Department of Internal Medicine, Ohio State University, Columbus, Ohio, USA.
14
Medical University of South Carolina, Charleston, South Carolina, USA.
15
Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, USA.
16
Yale School of Medicine, New Haven, Connecticut, USA.
17
Department of Internal Medicine, University of Chicago, Chicago, Illinois, USA.
18
Digestive Health Specialists, Tupelo, Mississippi, USA.
19
University of Florida, Gainesville, Florida, USA.
20
Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.

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.

PMID:
28741615
PMCID:
PMC6168293
DOI:
10.1038/ajg.2017.181
[Indexed for MEDLINE]
Free PMC Article

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