title: Risk of Diabetes Mellitus after First-Attack Acute Pancreatitis: A National Population-Based Study.
abstract: OBJECTIVE
  Population-based data on the risk of diabetes mellitus onset after acute pancreatitis (AP) are lacking. We assessed the incidence of diabetes in AP survivors compared with matched controls.
  
  
  METHODS
  The study cohort, drawn from Taiwan National Health Insurance claims data, included 2,966 first-attack AP patients and 11,864 non-AP general controls individually matched on age and sex, with an AP/non-AP ratio of 1:4. Incidence rate was estimated under Poisson assumption. Relative risks of diabetes were indicated by hazard ratios (HRs) estimated from Cox proportional hazard regression models with a partitioning of time at 3 months to account for proportionality.
  
  
  RESULTS
  In the first partition of time (<3 months), the incidences of diabetes were 60.8 and 8.0 per 1,000 person-years in AP and control groups, respectively; representing a covariate-adjusted HR of 5.90 (95% confidence interval (CI) 3.37-10.34). In the second partition (≥3 months), the incidences of diabetes were 22.5 and 6.7 per 1,000 person-years in AP and control groups, respectively (adjusted HR 2.54, 95% CI 2.13-3.04). In the second partition, the risk of diabetes was greater in men than in women (HR 3.21 vs. 1.58, P=0.0004). When the analyses were stratified by severity of AP, the results for mild AP were similar to those for all AP.
  
  
  CONCLUSIONS
  The risk of diabetes increases by twofold after AP; therefore, a long-term screening is necessary to evaluate diabetes after an attack regardless of severity. Further research should be conducted to develop cost-effective follow-up strategies, and to elucidate the underlying mechanisms of the relationship between diabetes and AP.
authors.affiliation: Department of Intensive Care Medicine, Chi Mei Medical Center, Yong-Kang District, Tainan, Taiwan.|Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Hsiu-Nien
authors.initials: HN
authors.lastname: Shen
authors.affiliation: Department of Intensive Care Medicine, Chi Mei Medical Center, Yong-Kang District, Tainan, Taiwan.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Yang
authors.affiliation: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Chang
authors.affiliation: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chin-Li
authors.initials: CL
authors.lastname: Lu
authors.affiliation: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications*; D016012:Poisson Distribution; D016016:Proportional Hazards Models; D012306:Risk; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology