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Curr Treat Options Gastroenterol. 2017 Dec;15(4):508-519. doi: 10.1007/s11938-017-0163-x.

Diabetes and the Pancreatobiliary Diseases.

Author information

1
Gastroenterology and Hepatology, Temple University Hospital, Philadelphia, PA, USA.
2
Division of Gastroenterology and Hepatology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, L461, Portland, OR, 97239, USA. Sharzehi@ohsu.edu.

Abstract

PURPOSE OF REVIEW:

The emphasis of this review article is to bring to the forefront the spectrum of pancreatobiliary disorders and their association with diabetes. We hope to systematically discuss the link between diabetes and disorders of the pancreas including acute and chronic pancreatitis, as well as pancreatic cancer. We also hope to review and highlight the literature with respect to other cancers of the biliary tree including gallbladder and cholangiocarcinoma. Lastly, we discuss diabetes and biliary dyskinesia.

RECENT FINDINGS:

Newer cohort studies suggest the presence of diabetes to increase the severity and worsen outcomes in acute pancreatitis. Post pancreatitis diabetes is a novel disease entity being increasingly recognized. The use of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis may attenuate the risk of endocrine dysfunction. Pancreatic cancer may either be the consequence of diabetes or a presenting manifestation. The use of anti-diabetic medications may confer protection against development of pancreatic cancer. Gallbladder adenocarcinoma and cholangiocarcinoma risks are elevated in those with underlying diabetes. Diabetes can directly impact or deteriorate outcome of acute and chronic pancreatitis and well as pancreatobiliary malignancies. It could also occur as a result of loss of endocrine function after pancreatitis. Like many areas of the digestive tract, biliary motility could be impacted by diabetes.

KEYWORDS:

Acute pancreatitis; Biliary carcinoma; Biliary dyskinesia; Chronic pancreatitis; Diabetes mellitus; Pancreatic carcinoma

PMID:
29079901
DOI:
10.1007/s11938-017-0163-x

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