Factors Affecting the Development of Diabetes Mellitus After Pancreatic Resection

Pancreas. 2015 Nov;44(8):1296-303. doi: 10.1097/MPA.0000000000000404.

Abstract

Objectives: Glucose homeostasis changes after pancreatic resection are not well understood. We aimed to identify the incidence of, and risk factors for, a change in glucose homeostasis in patients who underwent pancreatectomy for benign pancreatic tumors.

Methods: Clinical and pathological data from 229 patients were collected prospectively and analyzed retrospectively. The pancreas resection volume was calculated by computed tomography volumetry.

Results: After pancreatectomy, newly diagnosed diabetes mellitus (DM) occurred in 52 patients (22.7%) and impaired fasting glucose and impaired glucose tolerance occurred in 74 patients (32.3%). The incidence of DM was highest for patients who underwent distal pancreatectomy (DP) (30.5%). Patients in the DP group had a significantly increased rate of DM as the pancreatic resection volume (in milliliters) and resected volume ratio (in percent) increased. A high body mass index and older age were significant risk factors for the development of DM by multivariate analysis.

Conclusions: The resection volume of the pancreas is associated with a change in glucose homeostasis after pancreatectomy. Therefore, preservation of the pancreatic parenchyma is important to minimize the onset of DM in patients with a high pancreatic resected volume ratio (>35.6%) in DP, a high body mass index, or in old age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Blood Glucose / metabolism*
  • Body Mass Index
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / etiology
  • Fasting / blood
  • Female
  • Homeostasis
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pancreas / pathology
  • Pancreas / surgery*
  • Pancreatectomy / adverse effects
  • Pancreatectomy / methods*
  • Retrospective Studies
  • Risk Factors

Substances

  • Blood Glucose