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Use of Insulin and the Risk of Progression of Pancreatitis: A Population‐Based Cohort Study
Author(s) -
Cho Jaelim,
Scragg Robert,
Petrov Maxim S.
Publication year - 2020
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt.1644
Subject(s) - medicine , pancreatitis , diabetes mellitus , hazard ratio , insulin , proportional hazards model , confidence interval , acute pancreatitis , cohort , cohort study , population , endocrinology , gastroenterology , environmental health
Acute pancreatitis (AP) often progresses to recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP). We investigated the relationship between the use of insulin after AP and progression from AP to RAP or CP, as well as the effect of diabetes status on the relationship. Using nationwide pharmaceutical dispensing data and hospital discharge data, insulin‐naïve individuals were followed from first AP admission. Multivariable time‐dependent Cox regression analyses were conducted. In the overall cohort ( n = 10,190), ever‐use of insulin was associated with an increased risk of progression to RAP or CP (adjusted hazard ratio (HR), 1.70; 95% confidence interval (CI), 1.31–2.20). This risk remained increased in individuals with preexisting diabetes (adjusted HR, 1.45; 95% CI, 1.04–2.00), those with diabetes after AP (3.87; 1.20–12.46), and those without diabetes (2.80; 1.25–6.25). The findings suggest that individuals with AP who receive insulin are at a heightened risk of progression of pancreatitis, irrespective of diabetes status.