Abstract
Diabetes mellitus is a common complication of chronic pancreatitis and population-based studies show a two-fold increased risk of diabetes following acute pancreatitis. This makes post-pancreatitis diabetes the second commonest type of diabetes, but this entity has not been widely recognized. Post pancreatitis diabetes is traditionally considered to develop as a consequence of beta cell loss, which is associated with pancreatic atrophy and loss of pancreatic enzyme producing acinar cells. Pancreas-specific plasma amylase (P-amylase) reflects the functional reserve of pancreatic acinar cells and is associated with exocrine and endocrine pancreatic function. We hypothesize that patients with new onset diabetes mellitus and low levels of P-amylase will have phenotypic characteristics indicative of post-pancreatitis diabetes as compared to their counterparts with normal P-amylase levels. We plan to conduct a retrospective cohort study of patients with new onset diabetes included in the DD2 cohort with a concomitant assessment of P-amylase. Patients will be stratified into subgroups based on P-amylase levels. Subgroups will be compared in relation to demographics (age and gender), classic type 2 diabetes related risk factors (family history of diabetes and anthropometric assessment parameters) as well as parameters indicative of post-pancreatitis diabetes (past history of acute and chronic pancreatitis, risk factors for pancreatitis [alcohol and smoking history, triglycerides] and c-peptide). This study will provide pilot data on the prevalence and characteristics of post-pancreatitis diabetes that may stimulate further studies.
Formål
1. To characterize the distribution of P-amylase in a cohort of patients with new onset diabetes mellitus.
2. Based on P-amylase levels to characterize subgroups of patients with new onset diabetes mellitus in relation to demographics and classic type 2 diabetes related risk factors (family history of diabetes, anthropometric assessment parameters).
3. Based on P-amylase levels to characterize subgroups of patients with new onset diabetes mellitus in relation to factors indicative of post pancreatitis diabetes mellitus (past history of acute and chronic pancreatitis, risk factors for pancreatitis, c-peptide levels).
Studiepopulation
Patients with new-onset diabetes and a concomitant assessment of P-amylase are eligible for the study. Patients with positive GAD antibodies, indicative of type 1 diabetes mellitus, will be excluded. Also, patients with elevated creatinine levels (indicative of renal failure) will be excluded as this may influence the level of P-amylase. The study cohort is based on patient samples that have already been included and analyzed in the DD2 cohort.
Artikler
DD2 er ledet af Steno Diabetes Centrene
