Comparing clinical characteristics of pediatric patients with pancreatic diabetes to patients with type 1 diabetes: A matched case‐control study

Abstract

Background Only few studies have been conducted on pancreatic diabetes and data from large epidemiological studies are missing. Our main objective was to study the most important differences and similarities between pediatric individuals with pancreatic diabetes and type 1 diabetes (T1D). Methods Patients <20 years of age were identified from the diabetes patient follow‐up registry (DPV). Data of the most recent treatment year between January 2000 and March 2018 were aggregated. Propensity score was used to match individuals with pancreatic diabetes to individuals with T1D. Matching was conducted one‐to‐one by sex, age, diabetes duration, body mass index SD score (BMI‐SDS), and migration background. Results We studied 731 individuals with pancreatic diabetes and 74 460 with T1D. In the matched cohort of 631 pairs, HbA1c was significantly lower in pancreatic diabetes (7.4% [95% confidence interval: 7.2; 7.5%]) compared to T1D patients (8.7% [8.5; 8.8%]). Daily insulin dose (0.80 IU/kg [0.77; 0.84] vs 0.86 IU/kg [0.82; 0.90]) and insulin pump use (13.3% [10.7; 16.4] vs 22.1% [19.0; 25.6%]) were lower in patients with pancreatic diabetes. However, event rates of severe hypoglycemia were similar between pancreatic and T1D patients (8.8 [5.4; 14.2] vs 9.6 [5.9; 15.6] events per 100 patient years). Conclusions With the use of robust epidemiological data, our study improves the knowledge on clinical characteristics in pediatric individuals with pancreatic diabetes. Moreover, our results serve as a basis to reconsider treatment options and for discussing clinical practice guidelines for patients with this rare medical condition.

Hospitalization in Pediatric Diabetes: A Nationwide Analysis of all Admission Causes for Germany in 2015

“…In line with our results, the most frequent diagnosis was cystic fibrosis (84 %) and female individuals were preponderant (59 %) [33]. The authors also found, similarly to our findings, that children and adolescents with pancreatic diabetes had a twofold higher number of hospitalization days per person-year compared to peers with T1D [33].…”

“…As defined in the methods section, T3D represents a very heterogeneous group, mainly including diabetes due to disorders of the exocrine pancreas (pancreatic diabetes). Recently, clinical characteristics of children and adolescents under 20 year of age with pancreatic diabetes were examined in a German cohort [33]. In line with our results, the most frequent diagnosis was cystic fibrosis (84 %) and female individuals were preponderant (59 %) [33].…”

Comparing diabetes due to diseases of the exocrine pancreas to type 1 and type 2 diabetes using propensity score matching

“…Individuals with diabetes due to DEP, type 1 or type 2 diabetes ≥18 years of age, which were documented in the DPV database between January 2000 and March 2018 were included in the study. Characteristics of pediatric individuals with diabetes due to DEP from the DPV registry were published previously (14), therefore, we focused on adult individuals only, due to the clear etiologic differences between both groups. Data of the most recent treatment year was aggregated (median) for the analyses.…”