Risk factors and nomogram for diabetes mellitus in idiopathic chronic pancreatitis

Abstract

Background and Aim Diabetes mellitus (DM) is a common complication of idiopathic chronic pancreatitis (ICP), which impairs the quality of life for patients. This study aimed to identify risk factors and develop nomogram for DM in ICP to help early diagnosis. Methods Idiopathic chronic pancreatitis patients admitted to our center from January 2000 to December 2013 were included. Cumulative rates of DM were calculated by Kaplan–Meier method. Patients were randomly assigned, in a 2:1 ratio, to the training and validation cohort. Based on training cohort, risk factors for DM were identified through Cox proportional hazards regression model, and nomogram was developed. Internal and external validations were performed based on the training and validation cohort, respectively. Results Totally, 1633 patients with ICP were finally enrolled. The median follow‐up duration was 9.8 years. DM was found in 26.3% (430/1633) of patients after the onset of CP. Adult at onset of ICP, biliary stricture at/before diagnosis of CP, steatorrhea at/before diagnosis of CP, and complex pathologic changes in main pancreatic duct were identified risk factors for DM development. The nomogram achieved good concordance indexes in the training and validation cohorts, respectively, with well‐fitted calibration curves. Conclusions Risk factors were identified, and nomogram was developed to determine the risk of DM in ICP patients. Patients with one or more of the risk factors including adult at onset of ICP, biliary stricture at/before diagnosis of CP, steatorrhea at/before diagnosis of CP, and complex pathologic changes in main pancreatic duct have higher incidence of DM.

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

“…Alcohol-related pancreatitis was earlier thought to portend higher risk for PPDM with a study demonstrating a higher risk of developing DM in alcohol-related pancreatitis in comparison with idiopathic pancreatitis [ 24 ]. But, several studies since have found no difference in risk of PPDM between aetiologies of pancreatitis [ 25 , 26 ]. A meta-analysis including 8,970 patients did not find alcohol-related CP to be a risk factor for the development of DM [ 27 ].…”

Serum trypsin‐like immunoreactivity in dogs with diabetes mellitus

“…In humans, type 2 DM increases the risk for acute pancreatitis, although pathogenic mechanisms have not been clearly defined 48 ; conversely, acute and chronic pancreatitis also increase the risk of developing DM in humans. 49 , 50 In diabetic dogs, pancreatitis has been found to be a common comorbid condition diagnosed clinically, 9 , 51 but the diagnosis of pancreatitis heavily relies on increased pancreatic lipase and there is wide variability among studies regarding histological confirmation of pancreatitis in diabetic dogs. 7 , 52 , 53 , 54 Additionally, some dogs with chronic pancreatitis have impaired beta cell function, 55 and pancreatitis might lead to secondary destruction of pancreatic islets.…”

Risk factor analysis and nomogram development for steatorrhea in idiopathic chronic pancreatitis

“…Our previous studies have presented detailed information of Changhai CP Database version 2.1 (Shanghai, China). 15,[21][22][23][24][25][26][27][28][29] All patients included in this database were contacted for a final evaluation, apart from those who had died or lost to follow-up until December 2013.…”