Journal article
Detection, Evaluation and Treatment of Diabetes Mellitus in Chronic Pancreatitis: Recommendations from PancreasFest 2012
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], Vol.13(4), pp.336-342
2013
DOI: 10.1016/j.pan.2013.05.002
PMCID: PMC3830751
PMID: 23890130
Abstract
Description
Diabetes and glucose intolerance are common complications of chronic pancreatitis, yet clinical guidance on their detection, classification, and management is lacking.
Methods
A working group reviewed the medical problems, diagnostic methods, and treatment options for chronic pancreatitis-associated diabetes for a consensus meeting at PancreasFest 2012.
Results
Guidance Statement 1.1: Diabetes mellitus is common in chronic pancreatitis. While any patient with chronic pancreatitis should be monitored for development of diabetes, those with long-standing duration of disease, prior partial pancreatectomy, and early onset of calcific disease may be at higher risk. Those patients developing diabetes mellitus are likely to have co-existing pancreatic exocrine insufficiency.
Guidance Statement 1.2: Diabetes occurring secondary to chronic pancreatitis should be recognized as pancreatogenic diabetes (type 3c diabetes).
Guidance Statement 2.1: The initial evaluation should include fasting glucose and HbA1c. These tests should be repeated annually. Impairment in either fasting glucose or HbA1c requires further evaluation.
Guidance Statement 2.2: Impairment in either fasting glucose or HbA1c should be further evaluated by a standard 75 g oral glucose tolerance test.
Guidance Statement 2.3: An absent pancreatic polypeptide response to mixed-nutrient ingestion is a specific indicator of type 3c diabetes.
Guidance Statement 2.4: Assessment of pancreatic endocrine reserve, and importantly that of functional beta-cell mass, should be performed as part of the evaluation and follow-up for total pancreatectomy with islet autotransplantation (TPIAT).
Guidance Statement 3: Patients with pancreatic diabetes shall be treated with specifically tailored medical nutrition and pharmacologic therapies.
Conclusions
Physicians should evaluate and treat glucose intolerance in patients with pancreatitis.
Details
- Title: Subtitle
- Detection, Evaluation and Treatment of Diabetes Mellitus in Chronic Pancreatitis: Recommendations from PancreasFest 2012
- Creators
- Michael R Rickels - Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USAMelena Bellin - Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USAFrederico G.S Toledo - Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USAR. Paul Robertson - Pacific Northwest Diabetes Research Institute, Seattle, Washington, USADana K Andersen - Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, Maryland, USASuresh T Chari - Department of Medicine, Mayo Clinic, Rochester, Minnesota, USARandall Brand - Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USALuca Frulloni - Department of Medicine, University of Verona, Verona, ItalyMichelle A Anderson - Department of Medicine, University of Michigan, Ann Arbor, Michigan, USADavid C Whitcomb - Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USAPancreasFest Recommendation Conference Participants
- Contributors
- Aliye Uc (Contributor) - University of Iowa, Stead Family Department of Pediatrics
- Resource Type
- Journal article
- Publication Details
- Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], Vol.13(4), pp.336-342
- DOI
- 10.1016/j.pan.2013.05.002
- PMID
- 23890130
- PMCID
- PMC3830751
- NLM abbreviation
- Pancreatology
- ISSN
- 1424-3903
- eISSN
- 1424-3911
- Grant note
- R13 DK088452 || DK / National Institute of Diabetes and Digestive and Kidney Diseases : NIDDK R13 DK096904 || DK / National Institute of Diabetes and Digestive and Kidney Diseases : NIDDK
- Language
- English
- Date published
- 2013
- Academic Unit
- Stead Family Department of Pediatrics; Radiation Oncology; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984047734702771
Metrics
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