Decreased insulin sensitivity, β-cell compensation characterize NODAP

Individuals with new-onset prediabetes/diabetes after non-necrotizing acute pancreatitis (NODAP) more often have reduced insulin sensitivity, β-cell compensation, and no significant change in postprandial levels of glucagon and pancreatic polypeptide, suggests a study.

Twenty-nine individuals with NODAP and 29 age- and sex-matched healthy controls were included. After fasting for at least 8 h, participants received 12 oz of BOOST drink. Their blood samples were collected before and after stimulation to measure insulin, C-peptide, glucagon and pancreatic polypeptide.

The authors calculated the indices of insulin sensitivity (HOMA-IS, 1/fasting insulin, Raynaud and Matsuda) and insulin secretion (HOMA-β, Stumvoll, insulinogenic index 30’ and 60’). Repeated measures analyses were performed in both unadjusted and adjusted models.

Individuals with NODAP had significantly higher insulin and C-peptide levels than controls during mixed meal test in both unadjusted (p-both=0.001) and adjusted models (p=0.004 and p=0.006, respectively). Those with NODAP also had significantly higher HOMA-β (p=0.028) and Stumvoll index (p=0.013) but significantly lower HOMA-IS (p=0.005), 1/fasting insulin (p=0.018), Raynaud index (p=0.018) and Matsuda index (p=0.021).

No significant differences were observed in glucagon and pancreatic polypeptide levels between NODAP and controls during mixed meal test in both the unadjusted (p=0.345 and p=0.206, respectively) and adjusted models (p=0.359 and p=0.158, respectively).

“The above findings may help develop an evidence-based protocol with a view to optimize control of glucose homeostasis in NODAP,” the authors said.