Acute Pancreatitis in Association With Type 2 Diabetes and Antidiabetic Drugs: A population-based cohort study

• Published in: Diabetes care Vol. 33; no. 12; pp. 2580 - 2585
• Main Authors: Gonzalez-Perez, Antonio, Schlienger, Raymond G, Rodríguez, Luis A. García
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-12-2010
• Subjects: Acute Disease; Age Factors; Aged; Alcohol use; Analysis; Biological and medical sciences; Cancer; Case-Control Studies; Cohort Studies; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Diabetes therapy; Diabetes. Impaired glucose tolerance; Diabetics; Drug therapy; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Gastrointestinal diseases; Humans; Hypoglycemic agents; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Insulin - adverse effects; Insulin - therapeutic use; Male; Medical sciences; Metabolic diseases; Middle Aged; Miscellaneous; Original Research; Pancreas; Pancreatitis; Pancreatitis - epidemiology; Pancreatitis - etiology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sex Factors; Smoking; Studies; Type 2 diabetes; Endocrinopathy; Type 2 diabetes; Human; Drug; Nutrition; Acute; Pancreatitis; Metabolic diseases; Epidemiology; Statistical study; Hypoglycemic agent; Association; Cohort study; Digestive diseases; Population; Endocrinology; Public health; Pancreatic disease
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc10-0842

OBJECTIVE: Previous observational studies have found an increased risk of acute pancreatitis among type 2 diabetic patients. However, limited information is available on this association and specifically on the role of antidiabetic treatment. Our aim, therefore, was to further assess the risk of acute pancreatitis in adult patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: We performed a population-based case-control analysis nested in a cohort of 85,525 type 2 diabetic patients and 200,000 diabetes-free individuals from the general population using data from The Health Improvement Network database. Subjects were followed up to ascertain incident cases of acute pancreatitis. RESULTS: We identified 419 cases of acute pancreatitis, 243 in the general population and 176 in the diabetes cohort. Incidence rates were 30.1 and 54.0 per 100,000 person-years in the general population and the diabetes cohort, respectively. In the cohort analysis, the adjusted incidence rate ratio of acute pancreatitis in diabetic patients versus that in the general population was 1.77 (95% CI 1.46-2.15). The magnitude of this association decreased with adjustment for multiple factors in the nested case-control analysis (adjusted odds ratio 1.37 [95% CI 0.99-1.89]). Furthermore, we found that the risk of acute pancreatitis was decreased among insulin-treated diabetic patients (0.35 [0.20-0.61]). CONCLUSIONS: Type 2 diabetes may be associated with a slight increase in the risk of acute pancreatitis. We also found that insulin use in type 2 diabetes might decrease this risk. Further research is warranted to confirm these associations.