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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: Of adults with acute pancreatitis and glucose of more than 200 mg\/dL during hospitalization, 42.9% developed diabetes. Adults with hyperglycemia during pancreatitis should be prioritized for diabetes screening. Adults who experience hyperglycemia while hospitalized with acute pancreatitis may be at risk for developing diabetes within a few months, according to findings published in Diabetes Care. As Healio previously reported, the National Institute of Diabetes and Digestive and Kidney Diseases formed the DREAM study, a prospective study aimed at assessing how acute pancreatitis may impact diabetes risk. The study enrolled 395 adults aged 18 to 75 years without preexisting diabetes hospitalized with acute pancreatitis. Glucose measurements during hospitalization were obtained from medical records. Diabetes diagnoses after acute pancreatitis were determined during an outpatient appointment approximately 3 months after hospitalization.
Of the study group, 37.5% had hyperglycemia with glucose 140 mg\/dL or higher during hospitalization, and 7.1% had hyperglycemia with glucose of 200 mg\/dL or higher. During follow-up, 14.8% of those with hyperglycemia of at least 140 mg\/dL were diagnosed with diabetes compared with 1.2% of adults who did not have glucose reach 140 mg\/dL (P = .0001). Additionally, 42.9% of adults with hyperglycemia of at least 200 mg\/dL were diagnosed with diabetes within a few months compared with 3.5% of those who did not have glucose levels reach 200 mg\/dL (P = .0001). \u201cThe main [takeaway] is that health care providers should monitor their glucose during acute pancreatitis,\u201d Frederico G. S. Toledo, MD, professor of medicine at University of Pittsburgh, told Healio. \u201cIf they see that blood sugar exceeds 200 mg\/dL, they should be on alert.\u201d Healio spoke with study investigators Toledo and Kathleen M. Dungan, MD, MPH, professor at The Ohio State University Wexner Medical Center, about the DREAM study, how health care professionals can use the findings to risk stratify adults with acute pancreatitis, and next steps for future research. Healio: Why was it so important to conduct the DREAM study? Dungan: Acute pancreatitis is probably the most common cause of pancreatic diabetes. Optimizing detection at an early stage could help us prioritize resources and implement preventive measures. We wanted to look at the hospital period or the acute illness period to assess whether hyperglycemia might constitute an important predictor. While stress hyperglycemia is a known risk factor for future development of diabetes and acute pancreatitis, it could have important prognostic implications because we\u2019re talking about a potentially direct insult to the organ that\u2019s producing insulin. Frederico G. S. Toledo Toledo: Everyone is familiar with type 1 and type 2 diabetes, but there are other types of diabetes out there with their own unique characteristics. One of them is diabetes that results from pancreatitis. This is a distinct form of diabetes, and it happens because pancreatitis is an inflammatory condition that can damage both the exocrine and the endocrine components of the pancreas, resulting in islet injury and islet loss. Consequently, if patients get acute pancreatitis, they may develop diabetes. It could be shortly after if the pancreatitis episode is severe enough, or it can happen later on, even years later. Healio: What is the take-home message of these preliminary findings? Toledo: The message is that hyperglycemia during an episode of acute pancreatitis has prognostic significance in identifying individuals at short-term risk for developing diabetes. The risk is particularly elevated when glucose exceeds 200 mg\/dL, 42% of these patients will have diabetes within a few weeks or months. They either have diabetes onset concurrent with the pancreatitis episode, or will develop diabetes within a few weeks or months. These patients should be steered toward short-term outpatient follow-up care to test for diabetes and initiate treatment as needed. The other important message is that if the blood glucose exceeds 200 mg\/dL during the episode of acute pancreatitis, this should not automatically lead to a diagnosis of diabetes at that time. We observed that 57% of these patients subsequently improved and did not have diabetes when comprehensively tested within a few months. Although hyperglycemia in this context indicates a high risk for diabetes, but it does not confirm the diagnosis. Instead of diagnosing at this time, arrange for outpatient clinic follow-up in 3 to 4 months to evaluate for diabetes at that time. Dungan: I agree that was the most important take-home message. At the same time, everyone needs follow-up because their long-term diabetes risk is high as far as we know from other studies. That\u2019s what\u2019s going to be studied with longer-term follow-up of this cohort as well. In terms of hyperglycemia during acute pancreatitis, it was relatively common, but it was more tied to the acuity of illness as opposed to strict traditional type 2 diabetes risk factors. Age is the only one of the classic risk factors that was a predictor. Healio: How can these findings be used to assist health care professionals in determining diabetes risk after acute pancreatitis? And what should health care professionals do to follow these patients more closely? Dungan: There are no standard expectations on what kinds of monitoring protocols should be done during the acute pancreatitis episode. These findings would argue that we should be monitoring at least at the frequency that was conducted at the clinical centers in the study. We should use the outcomes of this particular analysis to risk-stratify patients. Those people having glucose over 200 mg\/dL during acute pancreatitis must be prioritized for early follow-up. Those who did not, you could safely delay. But again, people who don\u2019t have hyperglycemia during acute pancreatitis still need follow-up and diabetes screening. This allows health care providers and<\/p>\n","protected":false},"author":1,"featured_media":2600,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2599","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/2599","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2599"}],"version-history":[{"count":0,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/2599\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/media\/2600"}],"wp:attachment":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2599"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2599"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2599"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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