Introduction Several previous studies have reported the incidence of new-onset diabetes mellitus (NODM) after pancreatectomy. Nevertheless, the results were inconsistent. The true rate of NODM after distal pancreatectomy (DP) is still unknown.
Research design and methods The aim of this study was to investigate the incidence of and the risk factors for NODM after DP. This study enrolled patients who underwent DP between January 2004 and February 2016 at Peking Union Medical College Hospital. Patients with preoperative diabetes mellitus or diagnosed with pancreatic cancer were excluded. The primary outcome was NODM.
Results A total of 485 patients were enrolled. The median (IQR) of follow-up duration was 30.95 (9.26–180.30) months. The accumulative incidence of NODM was 8.9% at postoperative 6 months, 14.0% at postoperative year one, 22.3% at year three, 27.1% at year five, and 35.5% at year ten. Multivariate analysis showed that the risk of postoperative NODM was positively correlated with age (HR 1.029 (1.013–1.045), p<0.001), preoperative body mass index (BMI) (HR 1.042 (1.003–1.083), p=0.001), operative blood loss (HR 1.0003 (1.0002–1.0010), p<0.001), and length of resected pancreas (HR 1.079 (1.013–1.148), p=0.017). Moreover, concomitant splenectomy (HR 2.001 (1.202–3.331), p=0.008) was associated with significantly higher risk of postoperative NODM.
Conclusion NODM incidence increased with postoperative time progression. Age, BMI, surgical blood loss, length of resected pancreas and splenectomy were independent risk factors for NODM after DP.
Trial registration number NCT03030209.
- general surgery
- risk factors
- diabetes mellitus
- type 2
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MD, CX and NS contributed equally.
Contributors MD, CX, and NS analyzed the data, wrote and revised the manuscript. MD designed the study and supervised the whole project. CX, NS, SW, and GW collected, analyzed and discussed the data. MD, QL, TZ, GC, WW, JG and ZL performed the operations, supervised the project, analyzed and discussed the data, and revised the manuscript. All the authors approved to submit the final manuscript for publication consideration.
Funding This study was supported by the project of application and promotion of capital special clinical research from Beijing Municipal Science and Technology Commission (Z171100001017017018) and the Guangdong Medical Science and Technology Research Fund (A2018128).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study protocol was approved by the institutional review board and registered at the US National Institutes of Health (https://www.clinicaltrials.gov/).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data generated or used during the study are available from the corresponding author by request.
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