title: Incidence and precipitants of hospitalization for pancreatitis in people with diabetes: the Fremantle Diabetes Study.
abstract: OBJECTIVE
  To determine the relative risk of pancreatitis in diabetes, and to establish whether diabetes-related as well as recognized risk factors contribute.
  
  
  METHODS
  We studied 1426 participants [mean (SD) age 62.1 (13.3) years, 49.6% male, 90.9% type 2 diabetes, median (interquartile range) diabetes duration 4.0 (1.0-10.0) years] from the community-based Fremantle Diabetes Study Phase I and 5663 matched residents without diabetes from the same geographical area. Pancreatitis hospitalizations between 1982 and 2010 were ascertained using validated data linkage. For Fremantle Diabetes Study Phase I participants, chart review provided data on the likely causes of pancreatitis.
  
  
  RESULTS
  A total of 21 Fremantle Diabetes Study Phase I participants (1.5%) were hospitalized for pancreatitis before study entry vs 29 (0.5%) of contemporaneous residents without diabetes. During a mean (SD) of 12.1 (5.4) years of follow-up from entry, 22 (1.6%) Fremantle Diabetes Study Phase I participants were hospitalized for a first-ever episode of pancreatitis on 37 occasions (1.31/1000 person-years) compared with 58 (1.0%) residents without diabetes on 81 occasions during a mean (SD) 13.6 (4.8) years (0.75/1000 person-years). The age- and sex-adjusted hazard ratio (95% CI) for first-ever pancreatitis hospitalization in Fremantle Diabetes Study Phase I participants was 1.73 (1.06-2.83; P=0.029). Chart review of 17 of the 22 Fremantle Diabetes Study Phase I participants (77%) with incident pancreatitis and available case notes revealed that four (24%) presented without objective evidence of pancreatitis, seven (41%) presented with cholelithiasis, three (18%) with excessive alcohol consumption, two (12%) as a complication of elective endoscopic retrograde cholangiopancreatography, and one (6%) with hypertriglyceridaemia.
  
  
  CONCLUSIONS
  Consistent with previously published data, the risk of pancreatitis was higher in community-dwelling Fremantle Diabetes Study Phase I participants but conventional precipitants accounted for confirmed cases. These data question whether diabetes-specific risk factors cause or contribute to pancreatitis.
authors.affiliation: University of Western Australia, School of Medicine and Pharmacology, Fremantle Hospital, Fremantle, Australia.
authors.forename: T M E
authors.initials: TM
authors.lastname: Davis
authors.forename: J
authors.initials: J
authors.lastname: Drinkwater
authors.forename: W A
authors.initials: WA
authors.lastname: Davis
mesh_terms: D000208:Acute Disease; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D010195:Pancreatitis / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D012042:Registries; D012307:Risk Factors; D014904:Western Australia / Q000453:epidemiology