Photo Credit: Shidlovski
The following is a summary of “High Incidence of Diabetes Mellitus After Distal Pancreatectomy and Its Predictors: A Long-term Follow-up Study,” published in the March 2024 issue of Endocrinology by Imamura, et al.
Glucose tolerance tends to deteriorate following distal pancreatectomy (DP), yet the long-term incidence of this deterioration and the factors contributing to interindividual variability remain uncertain. For a study, researchers sought to examine changes in diabetes-related traits before and after DP and to determine the incidence of diabetes post-surgery along with its predictors.
Out of 493 registered patients, 117 underwent DP, and 56 nondiabetic patients before surgery were included in the study. Prospective assessments of glucose and endocrine function were conducted using a 75-g oral glucose tolerance test preoperatively, at 1 month post-DP, and every 6 months thereafter for up to 36 months. Pancreatic volumetry was performed using multidetector row computed tomography before and after surgery.
Insulin secretion decreased, and blood glucose levels worsened following DP. Residual pancreatic volume correlated significantly with insulin secretion reserve but not blood glucose levels or diabetes development. Among the 56 patients, 33 developed diabetes mellitus, resulting in a cumulative incidence of 74.1% at 36 months post-DP. Multivariate Cox regression analysis identified impaired glucose tolerance preoperatively, decreased insulinogenic index, and impaired glucose tolerance at 1 month post-DP as risk factors for diabetes post-DP.
Impaired glucose tolerance and diminished early-phase insulin response to glucose contribute to new-onset diabetes following DP, with the latter emerging as an additional factor in diabetes development, particularly evident when pancreatic beta cell mass decreases post-DP.