Faculty Collaboration Database

Diabetes Mellitus in Children with Acute Recurrent and Chronic Pancreatitis: Data From the INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE Cohort. J Pediatr Gastroenterol Nutr 2019 Nov;69(5):599-606

Date

10/28/2019

Pubmed ID

31651815

Pubmed Central ID

PMC6834233

DOI

10.1097/MPG.0000000000002482

Scopus ID

2-s2.0-85071738160 (requires institutional sign-in at Scopus site)   32 Citations

Abstract

OBJECTIVES: Adults with chronic pancreatitis (CP) have a high risk for developing pancreatogenic diabetes mellitus (DM), but little is known regarding potential risk factors for DM in children with acute recurrent pancreatitis (ARP) or CP. We compared demographic and clinical features of children with ARP or CP, with and without DM, in the INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE (INSPPIRE) registry.

METHODS: We reviewed the INSPPIRE database for the presence or absence of physician-diagnosed DM in 397 children, excluding those with total pancreatectomy with islet autotransplantation, enrolled from August 2012 to August 2017. Patient demographics, BMI percentile, age at disease onset, disease risk factors, disease burden, and treatments were compared between children with DM (n = 24) and without DM (n = 373).

RESULTS: Twenty-four children (6% of the cohort) had a diagnosis of DM. Five of 13 tested were positive for beta cell autoantibodies. The DM group was 4.2 years [95% confidence interval (CI) 3-5.4] older at first episode of acute pancreatitis, and tended to more often have hypertriglyceridemia [odds ratio (OR) 5.21 (1.33-17.05)], coexisting autoimmune disease [OR 3.94 (0.88-13.65)] or pancreatic atrophy [OR 3.64 (1.13, 11.59)].

CONCLUSION: Pancreatic atrophy may be more common among children with DM, suggesting more advanced exocrine disease. However, data in this exploratory cohort also suggest increased autoimmunity and hypertriglyceridemia in children with DM, suggesting that risk factors for type 1 and type 2 DM, respectively may play a role in mediating DM development in children with pancreatitis.

Author List

Bellin MD, Lowe M, Zimmerman MB, Wilschanski M, Werlin S, Troendle DM, Shah U, Schwarzenberg SJ, Pohl JF, Perito E, Ooi CY, Nathan JD, Morinville VD, McFerron BA, Mascarenhas MR, Maqbool A, Liu Q, Lin TK, Husain SZ, Himes R, Heyman MB, Gonska T, Giefer MJ, Gariepy CE, Freedman SD, Fishman DS, Barth B, Abu-El-Haija M, Uc A

Author

Steven L. Werlin MD Emeritus Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Child
Cohort Studies
Databases, Factual
Diabetes Mellitus, Type 2
Female
Global Health
Humans
Male
Pancreatitis
Pancreatitis, Chronic
Prevalence
Risk Factors