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

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.

FIGURE 1.

Study Flowchart * Excluded: (i) age <18 year, (ii) pregnancy, (iii) chronic pancreatitis, (iv) pancreatic neoplasm, (v) prior DM in the current admission or any previous calendar year admission, (vi) patients without prior calendar year admission, (vii) mortality during index admission, (viii) any December discharge (to allow for sufficient follow-up time), (ix) patients without same calendar-year readmissions. AP: acute pancreatitis, DM: diabetes mellitus