Postpancreatitis diabetes mellitus common but often treated as type 2 diabetes

Postpancreatitis diabetes mellitus (PPDM) occurs frequently in adults and is a common type of secondary diabetes, a study reports. Furthermore, PPDM is often misclassified and treated as type 2 diabetes, contrary to its requirement for special management considerations.

The study used data from a Danish nationwide population-based cohort study involving 398,456 individuals with adult-onset diabetes. Of these, 5,879 individuals (1.5 percent) had PPDM, 9,252 (2.3 percent) had type 1 diabetes, and the remaining (96.2 percent) had type 2 diabetes.

PPDM had an incidence rate of 7.9 (95 percent confidence interval [CI], 7.7–8.1) per 100,000 person-years, which is lower compared with type 1 diabetes’ incidence rate of 12.5 (95 percent CI, 12.2–12.7) per 100,000 person years. The corresponding incidence rate ratio was 0.6 (95 percent CI, 0.6–0.7; p<0.001).

Of note, there was a considerable number of patients with PPDM who were classified as having type 2 diabetes (44.9 percent) and prescribed sulfonylureas (25.2 percent) and incretin-based therapies (18.0 percent) that can potentially be harmful in PPDM.

Conversely, 35.0 percent of PPDM patients never received biguanides, which had been shown to confer survival gains in PPDM.

Compared with type 2 diabetes, PPDM was linked to increased insulin requirements (hazard ratio [HR], 3.10, 95 percent CI, 2.96–3.23; p<0.001), particularly among PPDM patients with chronic pancreatitis (HR, 4.30, 95 percent CI, 4.01–4.56; p<0.001).