Abstract

Objective Little data exist describing the change over time in islet function and glycemic control in patients with chronic pancreatitis (CP). Methods In 325 CP patients who underwent 2 mixed meal tolerance tests and/or glycated hemoglobin (HbA1c) levels, we estimated the rate of change in metabolic measures per 6 months and assessed the association between potential risk factors for diabetes and rate of change using multivariate regression models. Results Per 6-month time, HbA1c increased by 0.062% with a standard error of 0.029% (P = 0.037) and the ratio (area under the curve (AUC) C-peptide to AUC glucose from mixed meal tolerance testing) decreased by 0.0028 with a standard error of 0.0011 (P = 0.014). We observed more rapid decline in smokers (AUC C-peptide, P = 0.043) and patients with surgical drainage (AUC glucose, P = 0.001; ratio, P = 0.03) or with calcific pancreatitis (HbA1c, P = 0.003). In multivariate models, AUC C-peptide and ratio declined at a greater rate in smokers and HbA1c in those with pancreatic calcifications (both P < 0.05). Conclusions We observed a measurable decline in β-cell function and glycemic control in patients with CP. Patients with a history of tobacco smoking, surgical drainage, or pancreatic calcification may be at highest risk.

Original languageEnglish (US)
Pages (from-to)1160-1166
Number of pages7
JournalPancreas
Volume48
Issue number9
DOIs
StatePublished - Oct 1 2019

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Keywords

  • diabetes
  • insulin
  • islet
  • mixed meal
  • pancreatitis

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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