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

Abstract

// <![CDATA[ $('.header-date').hide();$('#titleAuthors').hide();$('#abstractHeader').hide(); // ]]> Jin-Ming Wu1, *, Te-Wei Ho1, *, Ching-Yao Yang1, Po-Huang Lee1 and Yu-Wen Tien1 1Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC *These authors equally contributed to this work Correspondence to: Yu-Wen Tien, email: ywtien5106@ntu.edu.tw Keywords: distal pancreatectomy; chronic pancreatitis; dyslipidemia; glucose metabolism; nationwide database Received: June 27, 2017 Accepted: January 19, 2018 Published: January 27, 2018 ABSTRACT 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.