Incidence and Risk Factors for New-Onset Diabetes Mellitus After Surgical Resection of Pancreatic Cystic Lesions: A MarketScan Study

Stephen A. Firkins, Phil A. Hart, Kyle Porter, Chien Wei Chiang, Jordan M. Cloyd, Mary Dillhoff, Luis F. Lara, Andrei Manilchuk, Georgios I. Papachristou, Timothy M. Pawlik, Allan Tsung, Darwin L. Conwell, Somashekar G. Krishna

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objectives There is a paucity of literature evaluating new-onset diabetes mellitus (NODM) after resection of pancreatic cystic lesions (PCLs). We sought to characterize the incidence and risk factors associated with NODM after partial pancreatectomy for PCLs. Methods We utilized the IBM MarketScan Database (2012-2018) to identify all nondiabetic adults who underwent partial pancreatectomy for PCLs. Patients with any other pancreatic disease were excluded. We performed Kaplan-Meier analysis and multivariable Cox proportional hazards regression to define the incidence and risk factors of postoperative NODM. Results Among 311 patients, the overall risk (95% confidence interval) of NODM was 9.1% (6.3-12.9%), 15.1% (11.3-20.2%), and 20.2% (15.3-26.4%) at 6, 12 and 24 months, respectively. Multivariable analysis (adjusted hazard ratio; 95% confidence interval) revealed that older age (1.97; 1.04-3.72; 55-64 vs 18-54 years), obesity (2.63; 1.35-5.12), hypertension (1.79; 1.01-3.17), and cardiovascular disease (2.54; 1.02-6.28) were independent predictors of NODM. Rates of NODM were similar after distal pancreatectomy versus pancreaticoduodenectomy. Conclusions Within 2 years, 1 in 5 patients without any other pancreatic disease will develop NODM after partial pancreatectomy for PCLs. Those with advanced age, metabolic syndrome features, and/or cardiovascular disease may benefit from preoperative counseling and intensive postoperative monitoring, education, and treatment for diabetes mellitus.

Original languageEnglish
Pages (from-to)427-434
Number of pages8
JournalPancreas
Volume51
Issue number5
DOIs
StatePublished - May 1 2022

Bibliographical note

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

Keywords

  • diabetes mellitus
  • intraductal papillary mucinous neoplasm
  • pancreatectomy
  • pancreatic cystic lesion
  • population database

ASJC Scopus subject areas

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

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