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Changes in glucose metabolism after distal pancreatectomy: a nationwide database study.

Oncotarget 2018 Februrary 17
Background: This population-based study evaluated changes in glucose metabolism after distal pancreatectomy (DP).

Methods: Data from the Taiwan National Health Insurance Research Database was collected from 2001 to 2010. Of 1,980 patients who underwent DP, 507 had diabetes and 1,410 did not.

Results: Of the 1,410 non-diabetic pre-DP patients, 312 (22.1%) developed newly-diagnosed diabetes after DP. Multiple logistic regression analysis revealed that dyslipidemia [hazard ratio = 1.940; 95% confidence interval = 1.362-2.763; P < 0.001] and chronic pancreatitis (hazard ratio = 2.428; 95% confidence interval = 1.889-3.121; P < 0.001) were significantly associated with the development of diabetes after DP. On the other hand, analysis of changes in glucose metabolism among 289 pre-DP diabetes without the use of insulin revealed that 173 (59.9%) had deteriorated glucose metabolism after DP.

Conclusion: Dyslipidemia and chronic pancreatitis are risk factors for the development of diabetes. Further, more than half of the pre-DP diabetes patients without the use of insulin had deterioration of glucose metabolism after DP. Therefore, clinicians should monitor glucose metabolism and clinical symptoms of hyperglycemia among DP patients.

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