title: Predictive factors for change of diabetes mellitus status after pancreatectomy in preoperative diabetic and nondiabetic patients.
abstract: BACKGROUND
  This study aimed to determine risk factors for exacerbation of diabetes mellitus (DM) after pancreatectomy.
  
  
  METHODS
  Medical records of 167 patients with benign and malignant pancreaticobiliary diseases who underwent pancreaticoduodenectomy or distal pancreatectomy were retrospectively analyzed. DM was diagnosed by diabetic history or American Diabetes Association criteria. Worsened and improved DM after pancreatectomy was defined when treatment intensity or insulin/oral antidiabetic drug dosage increased or decreased, respectively, postoperatively. Long-standing DM was defined as a duration of >2 years.
  
  
  RESULTS
  In 76 preoperative diabetic patients, worsened and improved DM was observed postoperatively in 46 (60.5 %) and 9 (11.8 %) patients, respectively. In 91 preoperative nondiabetic patients, 22 (24.2 %) developed new-onset DM after pancreatectomy. Multivariate logistic analysis of the preoperative diabetic patients demonstrated long-standing DM and malignancy as independent predictors for postoperative worsened DM. No patients with long-standing DM or insulin treatment experienced improved DM after pancreatectomy. Multivariate logistic analysis of the preoperative nondiabetic patients showed body mass index of ≥25 and hard pancreatic texture as independent risk factors for new-onset postoperative DM.
  
  
  CONCLUSIONS
  These results may enable preoperative evaluation of risk factors for worsened or new-onset DM after pancreatectomy and may help plan intensive care for patients at a high risk of postoperative worsened DM.
authors.affiliation: Department of Surgical Oncology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Hirata
authors.forename: Bunzo
authors.initials: B
authors.lastname: Nakata
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Amano
authors.forename: Sadaaki
authors.initials: S
authors.lastname: Yamazoe
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D000368:Aged; D001661:Biliary Tract Neoplasms / Q000150:complications* / Q000473:pathology; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy / Q000009:adverse effects*; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000473:pathology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011184:Postoperative Period; D012189:Retrospective Studies
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin