title: Glycemic control after total pancreatectomy for intraductal papillary mucinous neoplasm: an exploratory study.
abstract: Background. Glycemic control following total pancreatectomy (TP) has been thought to be difficult to manage. Diffuse intraductal papillary mucinous neoplasm (IPMN) is a potentially curable precursor to pancreatic adenocarcinoma, best treated by TP. Objective. Compare glycemic control in patients undergoing TP for IPMN to patients with type 1 diabetes mellitus (DM). Design/Setting. Retrospective cohort. Outcome Measure. Hemoglobin A1C(HbA1C) at 6, 12, 18, and 24 months after TP. In the control group, baseline was defined as 6 months prior to the first HbA1c measure. Results. Mean HgbA1C at each point of interest was similar between TP and type I DM patients (6 months (7.5% versus 7.7%, P = 0.52), 12 months (7.3% versus 8.0%, P = 0.081), 18 months (7.7% and 7.6%, P = 0.64), and at 24 months (7.3% versus 7.8%, P = 0.10)). Seven TP patients (50%) experienced a hypoglycemic event compared to 65 type 1 DM patients (65%, P = 0.38). Limitations. Small number of TP patients, retrospective design, lack of long-termfollowup. Conclusion. This suggests that glycemic control following TP for IPMNcan be well managed, similar to type 1 DM patients. Fear of DM following TP for IPMN should not preclude surgery when TP is indicated.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL 32224, USA.
authors.forename: Laith H
authors.initials: LH
authors.lastname: Jamil
authors.forename: Ana M
authors.initials: AM
authors.lastname: Chindris
authors.forename: Kanwar R S
authors.initials: KR
authors.lastname: Gill
authors.forename: Daniela
authors.initials: D
authors.lastname: Scimeca
authors.forename: John A
authors.initials: JA
authors.lastname: Stauffer
authors.forename: Michael G
authors.initials: MG
authors.lastname: Heckman
authors.forename: Shon E
authors.initials: SE
authors.lastname: Meek
authors.forename: Justin H
authors.initials: JH
authors.lastname: Nguyen
authors.forename: Horacio J
authors.initials: HJ
authors.lastname: Asbun
authors.forename: Massimo
authors.initials: M
authors.lastname: Raimondo
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Woodward
authors.forename: Michael B
authors.initials: MB
authors.lastname: Wallace