Patients with type 2 diabetes mellitus have higher risk for acute pancreatitis compared with those without diabetes

Girman, Cynthia J.; Kou, Tzuyung D.; Cai, Bing; Alexander, Charles M.; O’Neill, Edward A.; Williams-Herman, Debora; Katz, Leonid

doi:10.1111/j.1463-1326.2010.01231.x

Cited by 184 publications

(151 citation statements)

References 24 publications

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“…The etiology of acute pancreatitis is multifactorial including gallstones, chronic alcohol abuse, hypertriglyceridemia, obesity, diabetes mellitus, viral hepatitis and drugs [2].…”

Section: Discussionmentioning

confidence: 99%

“…Two large studies reported that patients with type 2 DM have 1.49-2.83 fold increased risk of acute pancreatitis compared to nondiabetics [2,3]. The exact cause of the increased risk of pancreatitis in diabetic patients is unclear, however, the known risk factors for pancreatitis appear more frequently in diabetic patients.…”

Section: Discussionmentioning

confidence: 99%

“…Other etiologic factors are biliary sludge and microlithiasis, smoking, hypertriglyceridemia, hypercalcemia, drugs, obesity, diabetes, infections and toxins, trauma, pancreas divisum, vascular disease, pregnancy and idiopathic [1]. Patients with diabetes mellitus have a 2 fold increase in the risk of pancreatitis due to factors such as obesity, gallstones, elevated triglycerides, and medications [2,3]. Obesity increases risk of pancreatitis and pancreas carcinoma due to increased inflammation [4].…”

mentioning

confidence: 99%

“…Eur Res J 2015;1 (2): [74][75][76][77] Kucukler et al mentioned limited data, because time frames upto appearance of pancreatitis is different, we assume that vildaglipitin related pancreatitis may be an idiosyncratic effect.…”

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confidence: 99%

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Acute pancreatitis and Type 2 Diabetes Mellitus; who is guilty?

Küçükler¹,

Şimşek²,

Bağlıcaklıoğlu³

et al. 2015

Eur Res J

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Many factors play a role in the etiology of acute pancreatitis and its pathogenesis is not fully understood. Dipeptidyl peptidase 4 (DPP-4) inhibitors are a new group of agents for the treatment of Diabetes Mellitus (DM). There are some controversies about specific adverse events such as pancreatitis and hypersensitivity reactions. A 50-year-old morbid obese woman presented with upper abdomen pain after the eating food, nausea and vomiting. She was diagnosed with type 2 diabetes mellitus 7 years ago. Vildagliptin had been added to her treatment six months ago. Abdominal examination revealed epigastric tenderness with guarding. Laboratory data revealed elevated pancreatic enzymes. Abdominal computed tomography (CT) showed features of pancreatitis. Vildagliptin was stopped and patient's symptoms had diminished in parallel with normalization of pancreatic enzymes; and at the 5th day patient was discharged with healthy condition. She was free of symptoms and all laboratory data were normal at the 30th day after discharge. It is important to keep in mind that diabetic patients have an increased risk of pancreatitis which may be related to obesity, hyperlipidemia and/or drugs. Received: 23.03.2015; Accepted: 05.06.2015: Published Online: 04.07.2015 Alcohol and gallstones are the etiology of chronic pancreatitis in many adults. Other etiologic factors are biliary sludge and microlithiasis, smoking, hypertriglyceridemia, hypercalcemia, drugs, obesity, diabetes, infections and toxins, trauma, pancreas divisum, vascular disease, pregnancy and idiopathic [1]. Patients with diabetes mellitus have a 2 fold increase in the risk of pancreatitis due to factors such as obesity, gallstones, elevated triglycerides, and medications [2,3]. Obesity increases risk of pancreatitis and pancreas carcinoma due to increased inflammation [4]. Incretin mimetics, glucagon-like peptide-1 receptor (GLP-1R) agonists and DPP-4 inhibitors are new anti-diabetic agents which can cause pancreatitis as side effect. Postmarketing events of acute pancreatitis have been reported in patients receiving sitagliptin, vildagliptin, or saxagliptin. Most of the cases with pancreatitis are reported with sitagliptin among DPP-4 inhibitors; although there are a few case reports related to vildagliptin, too. In this paper, we report a case of acute pancreatitis which may be associated DPP-4 inhibitors, obesity or DM itself. Case Report ABSTRACT 74

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“…The etiology of acute pancreatitis is multifactorial including gallstones, chronic alcohol abuse, hypertriglyceridemia, obesity, diabetes mellitus, viral hepatitis and drugs [2].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Acute pancreatitis and Type 2 Diabetes Mellitus; who is guilty?

Küçükler¹,

Şimşek²,

Bağlıcaklıoğlu³

et al. 2015

Eur Res J

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“…An additional challenge is selecting the appropriate control cases, because patients are frequently taking multiple medications and the diseases for which patients are receiving these medications may themselves be associated with an increased risk of AP, independent of the drugs being used for treatment. Th is appears to be an issue for studies evaluating possible drug-induced AP for patients being treated for type 2 diabetes mellitus ( 10,12 ), infl ammatory bowel disease ( 13 ), and human immunodefi ciency virus infection ( 14 ).…”

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confidence: 99%

Drug-Induced Acute Pancreatitis: Uncommon or Commonplace?

Grendell

2011

American Journal of Gastroenterology

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Many drugs have been implicated as causing acute pancreatitis (AP), mainly based on the recurrence of pancreatitis following rechallenge with a drug that the patient had been taking at the time of an initial episode of AP. However, estimates of the relative frequency with which drugs cause AP vary widely. This is largely because many patients may be taking a number of drugs, may have co-morbidities such as gallstone disease or hypertriglyceridemia, or may be consuming large amounts of alcohol, making it diffi cult to determine what actually is the primary cause of an episode of AP. Large, rigorously designed epidemdiological studies are needed to better defi ne the frequency with which the drugs in general cause AP and the specifi c risk of pancreatitis associated with any individual drug. Am J Gastroenterol 2011; 106:2189 -2191 doi: 10.1038/ajg.2011 Drugs have generally been considered to be a relatively uncommon cause of acute pancreatitis (AP), with an estimated incidence of 0.1 -2 % ( 1,2 ). However, a recent report of 170 cases of pancreatitis cared for at a single academic medical center in the Czech Republic concluded that drugs were the most likely cause in 5.3 % of cases, making drugs the third most frequent cause of AP aft er gallstones and alcohol ( 3 ). Another report, involving a retrospective review of 138 patients diagnosed with AP from a single center in France, attributed the etiology to drugs in 6.5 % of cases. However, the authors of this report qualifi ed this estimate by writing " Th is higher rate … must be examined with precaution due to the diffi culty in attributing causality " . ( 4 ).Indeed, it has not been easy to determine whether a specifi c drug is a cause of AP. More than 500 medications have been implicated, but most of the evidence comes from random case reports, with little in the way of sound epidemiological studies ( 5 ). When a case report describes a single exposure to a drug, no reliable conclusions can be made because case reports are oft en incomplete. Reports frequently do not even fully document a reliable diagnosis of AP and oft en have inadequate data regarding the drug dose and duration of treatment before the episode of AP and the extent of eff orts to exclude other common causes of AP. In addition, previous case reports and drug warnings from regulatory agencies may stimulate additional reporting because of heightened awareness of even the possibility a drug may cause AP. Also drugs that are widely used are more likely to be on the medication list of a patient with AP, regardless of the true cause; and new drugs are monitored much more closely for possible adverse eff ects than are medications which have been used for decades. As well stated in a recent review of drug-induced AP, " Th e incidence rates and relative risk of single drugs cannot be determined with the help of case reports alone " ( 2 ).However, one specifi c type of case report has been regarded as decisive in determining whether a drug is a likely cause of AP; i.e., a description of a well...

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Glucagon-like peptide analogues for type 2 diabetes mellitus

Shyangdan

Royle

Clar³

et al. 2011

Cochrane Database of Systematic Reviews

179

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Publisher statement: This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2011, Issue 10. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.' Shyangdan, D.S. et al. (2011). Glucagon-like peptide analogues for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD006423.

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Patients with type 2 diabetes mellitus have higher risk for acute pancreatitis compared with those without diabetes

Abstract: After adjusting for risk factors, patients with T2DM had an elevated risk of AP compared with patients without diabetes. Physicians should be aware of the increased risk in patients with T2DM, particularly in those with prior pancreatitis.

Cited by 184 publications

References 24 publications

Acute pancreatitis and Type 2 Diabetes Mellitus; who is guilty?

Acute pancreatitis and Type 2 Diabetes Mellitus; who is guilty?

Drug-Induced Acute Pancreatitis: Uncommon or Commonplace?

Glucagon-like peptide analogues for type 2 diabetes mellitus

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