Post-Pancreatectomy Diabetes Index: A Validated Score Predicting Diabetes Development after Major Pancreatectomy

Maxwell, Daniel W.; Jajja, Mohammad Raheel; Galindo, Rodolfo J.; Zhang, Chao; Nadeem, Syed Omair; Sweeney, John F.; Blair, Catherine M.; Sarmiento, Juan M.

doi:10.1016/j.jamcollsurg.2019.12.016

Cited by 23 publications

(14 citation statements)

References 25 publications

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“…Consequently, total pancreatectomy should be discussed only in the very rare cases of symptomatic multifocal pancreatic tumors that cannot be safely enucleated. Post-pancreatectomy diabetes is a classical complication encountered at 10 years in up to 16% of patients after pancreaticoduodenectomy and in 35% after distal pancreatectomy; therefore, physicians and patients should be aware of this risk before validating surgical indication and educate patients to avoid weight gain ( 146 , 147 ). Islet autotransplantation, now reimbursed through health insurance in France, could be an interesting option for limiting diabetes-associated morbidity; the procedure carries the risk of tumor occurrence in these genetically-determined diseases, although interesting results have been observed in pancreatic adenocarcinoma in an animal model ( 148 , 149 ).…”

Section: Digestive Neuroendocrine Neoplasms In Phakomatosesmentioning

confidence: 99%

Phakomatoses and Endocrine Gland Tumors: Noteworthy and (Not so) Rare Associations

Chevalier

Dupuis²,

Jannin

et al. 2021

Front. Endocrinol.

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Phakomatoses encompass a group of rare genetic diseases, such as von Hippel-Lindau syndrome (VHL), neurofibromatosis type 1 (NF1), tuberous sclerosis complex (TSC) and Cowden syndrome (CS). These disorders are due to molecular abnormalities on the RAS-PI3K-Akt-mTOR pathway for NF1, TSC and CS, and to hypoxia sensing for VHL. Phakomatoses share some phenotypic traits such as neurological, ophthalmological and cutaneous features. Patients with these diseases are also predisposed to developing multiple endocrine tissue tumors, e.g., pheochromocytomas/paragangliomas are frequent in VHL and NF1. All forms of phakomatoses except CS may be associated with digestive neuroendocrine tumors. More rarely, thyroid cancer and pituitary or parathyroid adenomas have been reported. These susceptibilities are noteworthy, because their occurrence rate, prognosis and management differ slightly from the sporadic forms. The aim of this review is to summarize current knowledge on endocrine glands tumors associated with VHL, NF1, TSC, and CS, especially neuroendocrine tumors and pheochromocytomas/paragangliomas. We particularly detail recent advances concerning prognosis and management, especially parenchyma-sparing surgery and medical targeted therapies such as mTOR, MEK and HIF-2 α inhibitors, which have shown truly encouraging results.

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Section: Digestive Neuroendocrine Neoplasms In Phakomatosesmentioning

confidence: 99%

Phakomatoses and Endocrine Gland Tumors: Noteworthy and (Not so) Rare Associations

Chevalier

Dupuis²,

Jannin

et al. 2021

Front. Endocrinol.

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“…Maxwell et al . 8 observed that preoperative hemoglobin HbA1c level, BMI (>30 kg/m 2 ), age (>65 years) and pancreatectomy are associated with the development of diabetes after pancreatectomy. However, to date, the effect of preoperative or postoperative CPI on future glycemic control and the requirement for insulin therapy after pancreatectomy has not been previously investigated, although low CPI was reported to correlate with the initiation of insulin therapy in type 2 diabetes patients 5 .…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

“…Regarding future glycemic control after pancreatectomy, we showed that postoperative CPI is associated with HbA1c values, and that both preoperative and postoperative CPI values are associated with the requirement for insulin therapy 6 months after surgery. Maxwell et al 8 observed that preoperative hemoglobin HbA1c level, BMI (>30 kg/m 2 ), age (>65 years) and pancreatectomy are associated with the development of diabetes after pancreatectomy. However, to date, the effect of preoperative or postoperative CPI on future glycemic control and the requirement for insulin therapy after pancreatectomy has not been previously investigated, although low CPI was reported to correlate with the initiation of insulin therapy in type 2 diabetes patients 5 .…”

Section: Discussionmentioning

confidence: 99%

“…In terms of the association between endogenous insulin secretion and the status of diabetes management in type 2 diabetes patients, Iwata et al 7 reported that insulin therapy was required with a specificity of >80% if CPI was <1.0. Although previous studies have identified preoperative glycosylated hemoglobin (HbA1c), body mass index (BMI), age and the procedure of pancreatic resection as risk factors for the development of diabetes after pancreatic resection [8][9][10] , the association between perioperative residual b-cell function evaluated using CPI and the status of diabetes management, including glycemic control and requirement for insulin therapy, after pancreatectomy has not yet been investigated.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative C‐peptide index is associated with the status of diabetes management after pancreatectomy

Shikata

Chujo

Enkaku

et al. 2022

J of Diabetes Invest

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Aims/Introduction: This study aimed to identify the clinical factors affecting postoperative residual pancreatic b-cell function, as assessed by the C-peptide index (CPI), and to investigate the association between perioperative CPI and the status of diabetes management after pancreatectomy. Materials and Methods: The associations between perioperative CPI and clinical background, including surgical procedures of pancreatectomy, were analyzed in 47 patients who underwent pancreatectomy, and were assessed for pre-and postoperative CPI. The association between perioperative CPI and glycemic control after pancreatectomy was investigated. Results: The low postoperative CPI group (CPI <0.7) had longer duration of diabetes (17.5 -14.5 vs 5.5 -11.0 years, P = 0.004), a higher percentage of sulfonylurea users (41.7 vs 8.7%, P = 0.003) and a greater number of drug categories used for diabetes treatment (1.9 -1.1 vs 0.8 -0.8, P <0.001) than did the high postoperative CPI group. Postoperative CPI was higher (1.4 -1.2 vs 0.7 -0.6, P = 0.039) in patients with low glycosylated hemoglobin (<7.0%) at 6 months after pancreatectomy; preoperative (2.0 -1.5 vs 0.7 -0.5, P = 0.012) and postoperative CPI (2.5 -1.4 vs 1.4 -1.1, P = 0.020) were higher in non-insulin users than in insulin users at 6 months after surgery. Conclusions: The duration of diabetes and preoperative diabetes treatment were associated with residual pancreatic b-cell function after pancreatectomy. Furthermore, perioperative b-cell function as assessed by CPI was associated with diabetes management status after pancreatectomy.

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Type 3c Diabetes

Charitou,

Al-Bahadili

2023

Contemporary Endocrinology

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Post-Pancreatectomy Diabetes Index: A Validated Score Predicting Diabetes Development after Major Pancreatectomy

Cited by 23 publications

References 25 publications

Phakomatoses and Endocrine Gland Tumors: Noteworthy and (Not so) Rare Associations

Phakomatoses and Endocrine Gland Tumors: Noteworthy and (Not so) Rare Associations

Perioperative C‐peptide index is associated with the status of diabetes management after pancreatectomy

Type 3c Diabetes

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