Adults with chronic pancreatitis (CP) are at significant risk of acquiring pancreatogenic diabetes mellitus (DM), but little is known about potential risk factors for DM in children with ARP or CP. In the International Study Group of Pediatric Pancreatitis: In Search of a CuRE (INSPIRE) registry, researchers evaluated demographic and clinical characteristics of children with ARP or CP, with and without DM. They examined the INSPIRE database for the prevalence or absence of physician-diagnosed diabetes in 397 children recruited from August 2012 to August 2017, omitting those who had complete pancreatectomy with islet autotransplantation. Patient demographics, BMI percentile, age of illness beginning, disease risk factors, disease burden, and therapies were compared between children with diabetes (n = 24) and children without diabetes (n = 373).
Diabetes was diagnosed in 24 children (6% of the cohort). Five of the thirteen people tested positive for beta-cell autoantibodies. At the time of the first episode of acute pancreatitis, the DM group was 4.2 years [95% CI 3–5.4] older, and they were more likely to 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)].
Pancreatic atrophy may be more likely in children with diabetes, indicating severe exocrine illness. However, results from this exploratory cohort reveal that children with DM had elevated autoimmunity and hypertriglyceridemia, indicating that risk factors for type 1 and type 2 DM, respectively, may play a role in mediating DM development in children with pancreatitis.
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