Post-pancreatitis diabetes mellitus: insight on optimal management with nutrition and lifestyle approaches

Singh, Amandeep; Aggarwal, Manik; Garg, Rajat; Stevens, Tyler; Chahal, Prabhleen

doi:10.1080/07853890.2022.2090601

Cited by 10 publications

(6 citation statements)

References 85 publications

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“…We speculate that the reason for these results may be the small sample size. According to large population-based studies, the severity of the initial AP episode, pancreatic necrosis, and etiology are not related to the risk of PPDM-A ( 3 , 4 , 32 ), which is consistent with our findings. However, several studies have reported that pancreatic necrosis is an independent risk factor for PPDM-A ( 16 , 34 ).…”

Section: Discussionsupporting

confidence: 91%

A radiomics model of contrast-enhanced computed tomography for predicting post-acute pancreatitis diabetes mellitus

Hu,

Yang,

Zeng

et al. 2024

Quant Imaging Med Surg

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Background Diabetes mellitus can occur after acute pancreatitis (AP), but the accurate quantitative methods to predict post-acute pancreatitis diabetes mellitus (PPDM-A) are lacking. This retrospective study aimed to establish a radiomics model based on contrast-enhanced computed tomography (CECT) for predicting PPDM-A. Methods A total of 374 patients with first-episode AP were retrospectively enrolled from two tertiary referral centers. There were 224 patients in the training cohort, 56 in the internal validation cohort, and 94 in the external validation cohort, and there were 86, 22, and 27 patients with PPDM-A in these cohorts, respectively. The clinical characteristics were collected from the hospital information system. A total of 2,398 radiomics features, including shape-based features, first-order histogram features, high order textural features, and transformed features, were extracted from the arterial- and venous-phase CECT images. Intraclass correlation coefficients were used to assess the intraobserver reliability and interobserver agreement. Random forest-based recursive feature elimination, collinearity analysis, and least absolute shrinkage and selection operator (LASSO) were used for selecting the final features. Three classification methods [eXtreme Gradient Boosting (XGBoost), Adaptive Boosting, and Decision Tree] were used to build three models and performances of the three models were compared. Each of the three classification methods were used to establish the clinical model, radiomics model, and combined model for predicting PPDM-A, resulting in a total of nine classifiers. The predictive performances of the models were evaluated by the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F1-score. Results Eleven radiomics features were selected after a reproducibility test and dimensionality reduction. Among the three classification methods, the XGBoost classifier showed better and more consistent performances. The AUC of the XGBoost’s radiomics model to predict PPDM-A in the training, internal, and external cohorts was good (0.964, 0.901, and 0.857, respectively). The AUC of the XGBoost’s combined model to predict PPDM-A in the training, internal, and external cohorts was good (0.980, 0.901, and 0.882, respectively). The AUC of the XGBoost’s clinical model to predict PPDM-A in the training, internal, and external cohorts did not perform well (0.685, 0.733, and 0.619, respectively). In the external validation cohort, the AUC of the XGBoost’s radiomics model was significantly higher than that of the clinical model (0.857 vs. 0.619, P<0.001), but there was no significant difference between the combined and radiomics models (0.882 vs. 0.857, P=0.317). Conclusions The radiomics model based on CECT performs well and can be used as an earl...

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Section: Discussionsupporting

confidence: 91%

A radiomics model of contrast-enhanced computed tomography for predicting post-acute pancreatitis diabetes mellitus

Hu,

Yang,

Zeng

et al. 2024

Quant Imaging Med Surg

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show abstract

“…Acute pancreatitis carries a risk of developing diabetes after pancreatitis. Compared with T2DM, post-pancreatitis diabetes is associated with poor glycemic control, a much higher insulin requirement, a higher risk of developing cancer, death at an earlier age, and a significantly higher risk of death [ 111 ].…”

Section: Discussionmentioning

confidence: 99%

“…The management of pancreatic diabetes after AP is difficult. In addition to routine diabetes care, including monitoring for nephropathy, retinopathy, and neuropathy, physicians must address complications related to pancreatitis, including post-pancreatitis pain, poor oral intake, psychological issues, exocrine pancreatic insufficiency, and vitamin and mineral deficiencies [ 111 ]. The management of pancreatic diabetes after AP includes behavioral/style interventions (e.g., abstinence from alcohol/substances, nutrition, pain control, exercise) and pharmacological therapies (e.g., pancreatic enzyme supplementation, insulin and oral hypoglycaemic therapies, and treatment of osteoporosis) [ 111 ].…”

Section: Clinical Severity Of Acute Pancreatitis and The Development ...mentioning

confidence: 99%

The Cause and Effect Relationship of Diabetes after Acute Pancreatitis

2023

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Acute pancreatitis (AP) is an acute inflammation of the pancreas associated with high morbidity and mortality. Endocrine pancreatic insufficiency secondary to AP has drawn increasing attention in recent years. The aim of this paper is to analyze the available clinical and experimental literature to determine the cause and effect relationship of diabetes type 3c (T3cDM; pancreatogenic diabetes) after acute pancreatitis. The clinico-pathological features and management challenges of pancreatogenic diabetes overlap with other secondary causes of diabetes. A complex pathogenesis involving pancreatic exocrine insufficiency, dysfunction of insulin secretion, and insulin resistance is likely the cause of T3cDM after AP. To obtain an improved understanding of the pathophysiology of diabetes after AP, more research is now needed to understand the risk of complications related to the pancreas and diabetes in these patients.

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“…Moreover, joint multidisciplinary participation is necessary to customize disease management strategies based on patient characteristics to prevent early disease progression. Notably, the optimal time to review glycosylated hemoglobin, FPG, and 2hPG is at least 3 months after discharge from the hospital to minimize discrepancies [ 31 ]. In terms of treatment, early treatment with biguanides with antitumor effects is beneficial.…”

Section: Discussionmentioning

confidence: 99%

Number of recurrences is significantly associated with the post-acute pancreatitis diabetes mellitus in a population with hypertriglyceridemic acute pancreatitis

Liu

Chen

et al. 2023

Lipids Health Dis

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Background Twenty-three percent of patients are diagnosed with diabetes mellitus after the first episode of acute pancreatitis. The incidence of post-acute pancreatitis diabetes mellitus is significantly higher than that of type 1 diabetes mellitus. Some studies have concluded that the all-cause mortality and worse prognosis of diabetes after pancreatitis are higher. We predicted that number of recurrences of pancreatitis would be significantly associated with the incidences of metabolic syndrome, abdominal obesity, and post-acute pancreatitis diabetes mellitus. Methods Patients admitted to our hospital for hypertriglyceridemic acute pancreatitis from 2013–2021 were selected for a cross-sectional study. Statistical analysis methods were used to analyze the effect of recurrences on the long-term prognosis of patients with hypertriglyceridemic acute pancreatitis. Results In this study, 101 patients with hypertriglyceridemic acute pancreatitis were included: 60 (59.41%) in the recurrent acute pancreatitis group and 41 (40.59%) in the only one episode of acute pancreatitis group. Among all hypertriglyceridemic acute pancreatitis patients, approximately 61.4% were diagnosed with abdominal obesity, 33.7% of patients are diagnosed with metabolic syndrome, 34.7% of patients are diagnosed with diabetes mellitus, and 21.8% of patients are diagnosed with post-acute pancreatitis diabetes mellitus. Recurrent acute pancreatitis were independent risk factors for post-acute pancreatitis diabetes mellitus in patients with hypertriglyceridemic acute pancreatitis (odds ratio [OR] = 3.964, 95% confidence interval [CI] = 1.230–12.774) and the risk of post-acute pancreatitis diabetes mellitus in patients with three or more recurrent episodes was 6.607 times higher than that in patients without recurrent episodes (OR = 6.607, 95% CI = 1.412–30.916). Conclusions Recurrence is an independent risk factor for the development of post-acute pancreatitis diabetes mellitus and is significantly associated with the number of recurrences.

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Post-pancreatitis diabetes mellitus: insight on optimal management with nutrition and lifestyle approaches

Cited by 10 publications

References 85 publications

A radiomics model of contrast-enhanced computed tomography for predicting post-acute pancreatitis diabetes mellitus

A radiomics model of contrast-enhanced computed tomography for predicting post-acute pancreatitis diabetes mellitus

The Cause and Effect Relationship of Diabetes after Acute Pancreatitis

Number of recurrences is significantly associated with the post-acute pancreatitis diabetes mellitus in a population with hypertriglyceridemic acute pancreatitis

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