Open AccessDiabetes Mellitus in Children with Acute Recurrent and Chronic Pancreatitis
Author(s) -
Bellin Melena D.,
Lowe Mark,
Zimmerman M. Bridget,
Wilschanski Michael,
Werlin Steven,
Troendle David M.,
Shah Uzma,
Schwarzenberg Sarah J.,
Pohl John F.,
Perito Emily,
Ooi Chee Yee,
Nathan Jaimie D.,
Morinville Veronique D.,
McFerron Brian A.,
Mascarenhas Maria R.,
Maqbool Asim,
Liu Quin,
Lin Tom K.,
Husain Sohail Z.,
Himes Ryan,
Heyman Melvin B.,
Gonska Tanja,
Giefer Matthew J.,
Gariepy Cheryl E.,
Freedman Steven D.,
Fishman Douglas S.,
Barth Bradley,
AbuElHaija Maisam,
Uc Aliye
Publication year - 2019
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000002482
Subject(s) - medicine , pancreatitis , hypertriglyceridemia , odds ratio , cohort , diabetes mellitus , acute pancreatitis , gastroenterology , pediatrics , endocrinology , triglyceride , cholesterol
Objectives: Adults with chronic pancreatitis (CP) have a high risk for developing pancreatogenic diabetes mellitus (DM), but little is known regarding potential risk factors for DM in children with acute recurrent pancreatitis (ARP) or CP. We compared demographic and clinical features of children with ARP or CP, with and without DM, in the INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE (INSPPIRE) registry. Methods: We reviewed the INSPPIRE database for the presence or absence of physician‐diagnosed DM in 397 children, excluding those with total pancreatectomy with islet autotransplantation, enrolled from August 2012 to August 2017. Patient demographics, BMI percentile, age at disease onset, disease risk factors, disease burden, and treatments were compared between children with DM (n = 24) and without DM (n = 373). Results: Twenty‐four children (6% of the cohort) had a diagnosis of DM. Five of 13 tested were positive for beta cell autoantibodies. The DM group was 4.2 years [95% confidence interval (CI) 3–5.4] older at first episode of acute pancreatitis, and tended to more often have hypertriglyceridemia [odds ratio (OR) 5.21 (1.33–17.05)], coexisting autoimmune disease [OR 3.94 (0.88–13.65)] or pancreatic atrophy [OR 3.64 (1.13, 11.59)]. Conclusion: Pancreatic atrophy may be more common among children with DM, suggesting more advanced exocrine disease. However, data in this exploratory cohort also suggest increased autoimmunity and hypertriglyceridemia in children with DM, suggesting that risk factors for type 1 and type 2 DM, respectively may play a role in mediating DM development in children with pancreatitis.