Identification of a Risk Profile for New-Onset Diabetes after Acute Pancreatitis

Stephen A. Firkins, Phil A. Hart, Georgios I. Papachristou, Luis F. Lara, Zobeida Cruz-Monserrate, Alice Hinton, Darwin L. Conwell, David P. Bradley, Somashekar G. Krishna

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives There is a paucity of studies evaluating predictors of new-onset diabetes mellitus (DM) after acute pancreatitis (AP-related DM). We used a population-based database to evaluate predictors of AP-related DM. Methods The Nationwide Readmissions Database (2010-2014) was used to identify all nondiabetic adults with an index primary diagnosis of AP. Multiple exclusions were applied to identify cohorts with and without AP-related DM. A case-control study was conducted to identify risk factors for developing AP-related DM within the calendar year. Results We identified 2510 subjects with AP-related DM and 40,308 controls with AP who did not develop DM. Multivariable analysis revealed that increasing age (50-64 years; adjusted odds ratio [aOR], 1.35; 95% confidence interval [CI], 1.14-1.60), male sex (aOR, 1.2; 95% CI, 1.03-1.40), lowest income quartile (aOR, 1.48; 95% CI, 1.18-1.84), Elixhauser comorbidity index of 3 or higher (aOR, 1.47; 95% CI, 1.23-1.75), components of metabolic syndrome (aOR, 2.12; 95% CI, 1.21-3.70), severe AP (aOR, 1.60; 95% CI, 1.34-1.90), and recurrent AP (aOR, 1.46; 95% CI, 1.24-1.72) were independently associated with increased risk of AP-related DM. Conclusions These population-level variables predictive of developing AP-related DM can potentially identify patients who may benefit from closer follow-up, intensive education, and implementation of preventative strategies.

Original languageEnglish
Pages (from-to)696-703
Number of pages8
JournalPancreas
Volume50
Issue number5
DOIs
StatePublished - 2021

Bibliographical note

Funding Information:
Key Words: diabetes, acute pancreatitis, population database, metabolic syndrome From the *Department of Internal Medicine, †Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center; ‡Division of Biostatistics, College of Public Health, The Ohio State University; and §Division of Endocrinology and Metabolism, The Ohio State University Wexner Medical Center, Columbus, OH. Received for publication July 10, 2020; accepted April 1, 2021. Address correspondence to: Somashekar G. Krishna, MD, MPH, FASGE, AGAF, Sections of Pancreatic Disorders and Advanced Endoscopy, Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 262, Columbus, OH 43210 (e‐mail: Somashekar.krishna@osumc.edu). All authors have approved the final version of this article. Research reported in this publication was supported by the National Cancer Institute and National Institute of Diabetes and Digestive and Kidney Diseases under award number U01DK108327 (P.A.H., L.F.L., Z.C.-M., D.L.C., and S.G.K.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors declare no conflict of interest. Study concept and design: S.A.F., A.H., and S.G.K.; acquisition of data: S.A.F. and A.H.; statistical analysis: A.H.; analysis and interpretation of data: S.A.F., P.A.H., A.H., S.G.K.; drafting of manuscript: S.A.F., P.A.H., D.P.B., S.G.K.; critical revision of manuscript for important intellectual content: S.A.F., P.A.H., G.I.P., L.F.L., Z.C.-M., A.H., D.L.C., D.P.B., and S.G.K.; study supervision and guarantor: S.G.K. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.pancreasjournal.com). Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MPA.0000000000001818

Funding Information:
Research reported in this publication was supported by the National Cancer Institute and National Institute of Diabetes and Digestive and Kidney Diseases under award number U01DK108327 (P.A.H., L.F.L., Z.C.-M., D.L.C., and S.G.K.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • acute pancreatitis
  • diabetes
  • metabolic syndrome
  • population database

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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