title: Glycemic Change After Pancreaticoduodenectomy: A Population-Based Study.
abstract: The purpose of this population-based study was to determine the change of glucose metabolism in patients undergoing pancreaticoduodenectomy (PD).We conducted a nationwide cohort study using data from Taiwan's National Health Insurance Research Database collected between 2000 and 2010. Our sample included 861 subjects with type 2 diabetes mellitus (DM) and 3914 subjects without DM.Of 861 subjects with type 2 diabetes, 174 patients (20.2%) experienced resolution of their diabetes after PD, including patients with pancreatic ductal adenocarcinoma (PDAC) (20.5%), and non-PDAC (20.1%). Using a multiple logistic regression model, we found that subjects with comorbid chronic pancreatitis (odds ratio, 0.356; 95% CI, 0.167-0.759; P = 0.007) and use of insulin (odds ratio, 0.265; 95% CI, 0.171-0.412; P < 0.001) had significantly lower rates of resolution of diabetes. In the 3914 subjects without diabetes, the only statistically significant comorbidity contributing to pancreatogenic diabetes was chronic pancreatitis (odds ratio, 1.446; 95% CI, 1.146-1.823; P = 0.002).Subjects with comorbid chronic pancreatitis and use of insulin had lower rates of resolution of DM after PD. In subjects without diabetes, chronic pancreatitis contributed significantly to the development of pancreatogenic DM.
authors.affiliation: From the Department of Surgery (J-MW, T-CK, C-YY, H-SL, Y-WT); Department of Nursing, National Taiwan University Hospital and National Taiwan University College of Medicine (P-YC, S-HH); and Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan, ROC (J-MW, T-WH, FL).
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Wu
authors.forename: Te-Wei
authors.initials: TW
authors.lastname: Ho
authors.forename: Ting-Chun
authors.initials: TC
authors.lastname: Kuo
authors.forename: Ching-Yao
authors.initials: CY
authors.lastname: Yang
authors.forename: Hong-Shiee
authors.initials: HS
authors.lastname: Lai
authors.forename: Pin-Yi
authors.initials: PY
authors.lastname: Chiang
authors.forename: Su-Hua
authors.initials: SH
authors.lastname: Hsieh
authors.forename: Feipei
authors.initials: F
authors.lastname: Lai
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Tien
mesh_terms: D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D050500:Pancreatitis, Chronic / Q000378:metabolism*; D013624:Taiwan