Journal article
Incidence and Severity of Pancreatogenic Diabetes After Pancreatic Resection
Journal of gastrointestinal surgery, v 19(2), pp 217-225
01 Feb 2015
PMID: 25316483
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
While many patients experience prolonged survival after pancreatic resection for benign or malignant disease, the long-term risk of pancreatogenic diabetes mellitus (DM) remains poorly characterized.
Methods
One thousand one hundred seven patients underwent pancreatectomy at Thomas Jefferson University between 2006 and 2013. Attempts were made to contact all living patients by telephone and a DM-focused questionnaire was administered.
Results
Two hundred fifty-nine of 691 (37 %) surviving patients completed the survey, including 179 pancreaticoduodenectomies (PD), 78 distal pancreatectomies (DP), and 2 total pancreatectomies. In the PD group, 44 (25 %) patients reported having DM prior to resection. Of these, 5 (12 %) had improved glucose control after resection and 21 (48 %) reported escalated DM medication requirements post-resection. Of 135 PD patients without preoperative DM, 24 (18 %) had new-onset DM postoperatively. In the DP group, 23 patients (29 %) had DM preoperatively. None had improved glucose control after resection, while six (26 %) had worse control after resection. Seventeen of 55 DP patients (31 %) without preoperative DM developed new-onset DM postoperatively (
p
= 0.04 vs. PD). Preoperative HgbA1C >6.0 %, glucose >124 mg/dL, and insulin use >2 units per day were associated with an increased risk of new-onset postoperative DM.
Conclusions
The development or worsening of DM after pancreatic resection is extremely common, with different types of resections conveying different risks for disease progression. DP places patients at a greater risk for the development of new-onset postoperative diabetes when compared to PD. In contrast, patients with preoperative diabetes are more likely to experience worsening of their disease after PD as compared to DP. Patients should be screened prospectively, particularly those at highest risk, and informed of and educated about the potential for post-resection DM.
Metrics
Details
- Title
- Incidence and Severity of Pancreatogenic Diabetes After Pancreatic Resection
- Creators
- Richard A. Burkhart - Thomas Jefferson University HospitalSusan M. Gerber - Rowan UniversityRenee M. Tholey - Thomas Jefferson University HospitalKathleen M. Lamb - Thomas Jefferson University HospitalAnitha Somasundaram - Thomas Jefferson University HospitalCaitlin A. McIntyre - Thomas Jefferson University HospitalEliza C. Fradkin - Thomas Jefferson University HospitalAnnie P. Ashok - Thomas Jefferson University HospitalRobert F. Felte - Thomas Jefferson University HospitalJaya M. Mehta - Thomas Jefferson University HospitalErnest L. Rosato - Thomas Jefferson University HospitalHarish Lavu - Thomas Jefferson University HospitalSerge A. Jabbour - Thomas Jefferson University HospitalCharles J. Yeo - Thomas Jefferson University HospitalJordan M. Winter - Thomas Jefferson University Hospital
- Publication Details
- Journal of gastrointestinal surgery, v 19(2), pp 217-225
- Publisher
- Springer US
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000348399800002
- Scopus ID
- 2-s2.0-84921866451
- Other Identifier
- 991021937443104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Gastroenterology & Hepatology
- Surgery