Risk factors for new-onset diabetes mellitus following acute pancreatitis: a prospective study

- OBJECTIVE: Acute pancreatitis (AP) is increasingly recognized as a major cause of diabetes, however, the frequency and risk fac-tors associated with new-onset diabetes are not well established. We aimed to assess the frequency and risk factors associated with new-onset diabetes, the time of diabetes occurrence, and the difference between early and late-onset diabetes following an AP episode. PATIENTS AND METHODS: This prospective study included adult patients with AP admitted to a tertiary referral center, followed-up for one year to assess the occurrence of postpancre-atitis diabetes. Diabetes was defined in accor-dance with World Health Organization criteria and the severity of AP was assessed based on the 2012 revised Atlanta classification. RESULTS: Of 329 patients with AP, 29 (8.8%) were diagnosed with diabetes secondary to AP. Of these, 21 (6.37%) had early-onset dia-betes (within one month after the acute epi-sode) whereas 8 (2.42%) had late-onset diabe-tes (more than one month after the AP episode). Obesity and acute necrosis were more frequent in patients with new-onset diabetes compared to those without (55.2% vs. 33.4%, p=0.040 and 31% vs. 7.7%, p<0.01), and remained statistical-ly significant in multivariate analysis. No statisti-cally significant differences were found between these groups regarding sex, age, etiology and severity of AP. The patients with early-onset di-abetes were older than those with late-onset (61 vs. 45 years old), in univariate and multivariate analysis (p=0.018 and p=0.038, OR=0.87). CONCLUSIONS: Less than 10% of patients with AP developed diabetes within 1 year, par-ticularly obese patients and those with acute pancreatic necrosis of more than 50%. Patients aged over 61 years old developed diabetes in the first month after the acute episode of AP.