Patient and Disease Characteristics Associated with the Presence of Diabetes Mellitus in Adults with Chronic Pancreatitis in the United States

Melena D Bellin, David C. Whitcomb, Judah Abberbock, Stuart Sherman, Bimaljit S. Sandhu, Timothy B. Gardner, Michelle A. Anderson, Michele D. Lewis, Samer Alkaade, Vikesh K. Singh, John Baillie, Peter A. Banks, Darwin Conwell, Gregory A. Cote, Nalini M. Guda, Thiruvengadam Muniraj, Gong Tang, Randall E. Brand, Andres Gelrud, Stephen T. AmannChristopher E. Forsmark, C. Mel Wilcox, Adam Slivka, Dhiraj Yadav

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Abstract

Objectives:Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies.Methods:Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers. Questionnaires were completed by patients and physicians in a cross-sectional assessment. Patient demographics and disease characteristics were compared for CP with DM vs. without DM. Logistic regression was performed to assess the variables associated with DM diagnosis in a multivariable model.Results:Diabetics were more likely to be black (P=0.02), overweight, or obese (P<0.001), and with a family history of DM (P=0.0005). CP patients with DM were more likely to have pancreatic calcifications (63% vs. 54%, P=0.002), atrophy (44% vs. 32%, P<0.0001), and prior pancreas surgery (26.9% vs. 16.9%, P<0.0001). In multivariate logistic regression modeling, the strongest risk factors for DM were obesity (odds ratio (OR) 2.8, 95% confidence interval (CI) 1.9, 4.2) and exocrine insufficiency (OR 2.4, 95% CI 1.8, 3.2).Conclusions:In this large multicenter cohort of patients with CP, exocrine insufficiency, calcifications, and pancreas surgery conveyed higher odds of having DM. However, the traditional 'type 2 DM' risk factors of obesity and family history were similarly important in conveying risk for DM.

Original languageEnglish (US)
Pages (from-to)1457-1465
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume112
Issue number9
DOIs
StatePublished - Sep 1 2017

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Chronic Pancreatitis
Diabetes Mellitus
Pancreas
Obesity
Logistic Models
Odds Ratio
Confidence Intervals
Inborn Genetic Diseases
Pancreatitis
Type 2 Diabetes Mellitus
Atrophy
Demography

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Patient and Disease Characteristics Associated with the Presence of Diabetes Mellitus in Adults with Chronic Pancreatitis in the United States. / Bellin, Melena D; Whitcomb, David C.; Abberbock, Judah; Sherman, Stuart; Sandhu, Bimaljit S.; Gardner, Timothy B.; Anderson, Michelle A.; Lewis, Michele D.; Alkaade, Samer; Singh, Vikesh K.; Baillie, John; Banks, Peter A.; Conwell, Darwin; Cote, Gregory A.; Guda, Nalini M.; Muniraj, Thiruvengadam; Tang, Gong; Brand, Randall E.; Gelrud, Andres; Amann, Stephen T.; Forsmark, Christopher E.; Wilcox, C. Mel; Slivka, Adam; Yadav, Dhiraj.

In: American Journal of Gastroenterology, Vol. 112, No. 9, 01.09.2017, p. 1457-1465.

Research output: Contribution to journalArticle

Bellin, MD, Whitcomb, DC, Abberbock, J, Sherman, S, Sandhu, BS, Gardner, TB, Anderson, MA, Lewis, MD, Alkaade, S, Singh, VK, Baillie, J, Banks, PA, Conwell, D, Cote, GA, Guda, NM, Muniraj, T, Tang, G, Brand, RE, Gelrud, A, Amann, ST, Forsmark, CE, Wilcox, CM, Slivka, A & Yadav, D 2017, 'Patient and Disease Characteristics Associated with the Presence of Diabetes Mellitus in Adults with Chronic Pancreatitis in the United States', American Journal of Gastroenterology, vol. 112, no. 9, pp. 1457-1465. https://doi.org/10.1038/ajg.2017.181
Bellin, Melena D ; Whitcomb, David C. ; Abberbock, Judah ; Sherman, Stuart ; Sandhu, Bimaljit S. ; Gardner, Timothy B. ; Anderson, Michelle A. ; Lewis, Michele D. ; Alkaade, Samer ; Singh, Vikesh K. ; Baillie, John ; Banks, Peter A. ; Conwell, Darwin ; Cote, Gregory A. ; Guda, Nalini M. ; Muniraj, Thiruvengadam ; Tang, Gong ; Brand, Randall E. ; Gelrud, Andres ; Amann, Stephen T. ; Forsmark, Christopher E. ; Wilcox, C. Mel ; Slivka, Adam ; Yadav, Dhiraj. / Patient and Disease Characteristics Associated with the Presence of Diabetes Mellitus in Adults with Chronic Pancreatitis in the United States. In: American Journal of Gastroenterology. 2017 ; Vol. 112, No. 9. pp. 1457-1465.
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abstract = "Objectives:Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies.Methods:Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers. Questionnaires were completed by patients and physicians in a cross-sectional assessment. Patient demographics and disease characteristics were compared for CP with DM vs. without DM. Logistic regression was performed to assess the variables associated with DM diagnosis in a multivariable model.Results:Diabetics were more likely to be black (P=0.02), overweight, or obese (P<0.001), and with a family history of DM (P=0.0005). CP patients with DM were more likely to have pancreatic calcifications (63{\%} vs. 54{\%}, P=0.002), atrophy (44{\%} vs. 32{\%}, P<0.0001), and prior pancreas surgery (26.9{\%} vs. 16.9{\%}, P<0.0001). In multivariate logistic regression modeling, the strongest risk factors for DM were obesity (odds ratio (OR) 2.8, 95{\%} confidence interval (CI) 1.9, 4.2) and exocrine insufficiency (OR 2.4, 95{\%} CI 1.8, 3.2).Conclusions:In this large multicenter cohort of patients with CP, exocrine insufficiency, calcifications, and pancreas surgery conveyed higher odds of having DM. However, the traditional 'type 2 DM' risk factors of obesity and family history were similarly important in conveying risk for DM.",
author = "Bellin, {Melena D} and Whitcomb, {David C.} and Judah Abberbock and Stuart Sherman and Sandhu, {Bimaljit S.} and Gardner, {Timothy B.} and Anderson, {Michelle A.} and Lewis, {Michele D.} and Samer Alkaade and Singh, {Vikesh K.} and John Baillie and Banks, {Peter A.} and Darwin Conwell and Cote, {Gregory A.} and Guda, {Nalini M.} and Thiruvengadam Muniraj and Gong Tang and Brand, {Randall E.} and Andres Gelrud and Amann, {Stephen T.} and Forsmark, {Christopher E.} and Wilcox, {C. Mel} and Adam Slivka and Dhiraj Yadav",
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T1 - Patient and Disease Characteristics Associated with the Presence of Diabetes Mellitus in Adults with Chronic Pancreatitis in the United States

AU - Bellin, Melena D

AU - Whitcomb, David C.

AU - Abberbock, Judah

AU - Sherman, Stuart

AU - Sandhu, Bimaljit S.

AU - Gardner, Timothy B.

AU - Anderson, Michelle A.

AU - Lewis, Michele D.

AU - Alkaade, Samer

AU - Singh, Vikesh K.

AU - Baillie, John

AU - Banks, Peter A.

AU - Conwell, Darwin

AU - Cote, Gregory A.

AU - Guda, Nalini M.

AU - Muniraj, Thiruvengadam

AU - Tang, Gong

AU - Brand, Randall E.

AU - Gelrud, Andres

AU - Amann, Stephen T.

AU - Forsmark, Christopher E.

AU - Wilcox, C. Mel

AU - Slivka, Adam

AU - Yadav, Dhiraj

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Objectives:Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies.Methods:Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers. Questionnaires were completed by patients and physicians in a cross-sectional assessment. Patient demographics and disease characteristics were compared for CP with DM vs. without DM. Logistic regression was performed to assess the variables associated with DM diagnosis in a multivariable model.Results:Diabetics were more likely to be black (P=0.02), overweight, or obese (P<0.001), and with a family history of DM (P=0.0005). CP patients with DM were more likely to have pancreatic calcifications (63% vs. 54%, P=0.002), atrophy (44% vs. 32%, P<0.0001), and prior pancreas surgery (26.9% vs. 16.9%, P<0.0001). In multivariate logistic regression modeling, the strongest risk factors for DM were obesity (odds ratio (OR) 2.8, 95% confidence interval (CI) 1.9, 4.2) and exocrine insufficiency (OR 2.4, 95% CI 1.8, 3.2).Conclusions:In this large multicenter cohort of patients with CP, exocrine insufficiency, calcifications, and pancreas surgery conveyed higher odds of having DM. However, the traditional 'type 2 DM' risk factors of obesity and family history were similarly important in conveying risk for DM.

AB - Objectives:Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies.Methods:Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers. Questionnaires were completed by patients and physicians in a cross-sectional assessment. Patient demographics and disease characteristics were compared for CP with DM vs. without DM. Logistic regression was performed to assess the variables associated with DM diagnosis in a multivariable model.Results:Diabetics were more likely to be black (P=0.02), overweight, or obese (P<0.001), and with a family history of DM (P=0.0005). CP patients with DM were more likely to have pancreatic calcifications (63% vs. 54%, P=0.002), atrophy (44% vs. 32%, P<0.0001), and prior pancreas surgery (26.9% vs. 16.9%, P<0.0001). In multivariate logistic regression modeling, the strongest risk factors for DM were obesity (odds ratio (OR) 2.8, 95% confidence interval (CI) 1.9, 4.2) and exocrine insufficiency (OR 2.4, 95% CI 1.8, 3.2).Conclusions:In this large multicenter cohort of patients with CP, exocrine insufficiency, calcifications, and pancreas surgery conveyed higher odds of having DM. However, the traditional 'type 2 DM' risk factors of obesity and family history were similarly important in conveying risk for DM.

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