By Anne Harding
NEW YORK (Reuters Health) - A single episode of pancreatitis in childhood is associated with a higher risk of developing type 2 diabetes in adulthood, according to new findings.
"Children and adolescents with pancreatitis may require a tighter follow-up for their glucose levels and a careful control of modifiable diabetes risk factors following an event of acute pancreatitis that has been resolved," Dr. Gilad Twig of Hebrew University in Jerusalem, senior author of the study, told Reuters Health by email. "This risk is most pronounced by age 40 years and seems independent of adolescent BMI status."
The incidence of acute pancreatitis in pediatric patients has risen fivefold over the past 20 years, Dr. Twig and his colleagues note in Diabetes Care, online November 6. A National Institutes of Health-funded study of risk factors for and outcomes of pediatric acute recurrent and chronic pancreatitis is underway, they add, but nonrecurrent acute pancreatitis has not been studied, and it is unclear whether it is associated with increased diabetes risk.
To investigate, they looked at 1.8 million Israeli adolescents who underwent medical exams in 1979-2008 before starting military service. There were 394 participants with a history of childhood pancreatitis, including 281 with acute resolved pancreatitis and 113 with chronic pancreatic disease, all of whom had normal pancreatic function at study enrollment.
Thirteen (4.63%) of the patients with resolved pancreatitis developed diabetes during follow-up, compared to 44,463 (2.47%) of those with no history of pancreatic disease. Nine (8%) of the chronic-pancreatitis group developed diabetes.
The adjusted odds ratio for incident diabetes was 2.23 for study participants with a history of resolved pancreatitis and 6.19 for those with a history of chronic pancreatic disease, both significant risk increases.
Individuals with a history of childhood pancreatitis developed diabetes at a mean age of 36.4 years, versus 40.7 years for the unexposed group. Ninety-two percent of those with a history of childhood pancreatitis who developed diabetes were diagnosed before age 40, versus 47% of those with no history of pancreatitis.
"Since type 2 diabetes is potentially preventable, early risk reduction and careful follow-up may mitigate diabetes risk in these patients," Dr. Twig said. "History of previous pancreatic insult at childhood or adolescence (even if apparently clinically resolved) should be considered when counseling patients on their diabetes risk."
Diabetes Care 2019.