Journal article
Early mechanisms of diabetes development in pediatric pancreatitis: A pilot study
Journal of pediatric gastroenterology and nutrition, Vol.82(2), pp.549-556
02/2026
DOI: 10.1002/jpn3.70263
PMID: 41251022
Abstract
Approximately 9% of children with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP) have pancreatogenic diabetes during childhood; lifetime risk approaches 50%. To date, data are limited on pathophysiology and biomarkers identifying those at highest risk. This pilot study investigated glycemic physiology in children with ARP or CP.
Children (5-21 years) with an established diagnosis of CP or ARP, and participants of INSPPIRE-2 (INternational Study Group of Pediatric Pancreatitis: In search for a cuRE) were enrolled. Mixed meal tolerance testing (MMTT) measured glucose, insulin, C-peptide, glucagon, glucagon-like peptide-1 (GLP-1) and pancreatic polypeptide (PP) at -5, -1, 0, 30, 60, 90, 120 min before/after a Boost HP beverage. Other measures included hemoglobin A1c, continuous glucose monitoring (CGM, Dexcom Pro), HLA haplotype, and diabetes autoantibodies. Glycemic variability metrics were calculated using "cgmanalysis." Dysglycemia was defined by fasting glucose ≥100 mg/dL or HbA1c ≥ 5.7%.
Twenty participants were enrolled (mean age 16.3 years; 65% female, 60% non-Hispanic white, 2 with pre-existing diabetes). Mean HbA1c was 5.7% (range 5.0-8.9); 7/20 had dysglycemia, 1 with previously unrecognized diabetes. Those with dysglycemia differed from normoglycemic participants by having greater insulin resistance, lower GLP-1, and trend toward lower insulin and C-peptide but higher PP on MMTT.
In this small study, 35% of children with pancreatitis had dysglycemia, which may be mechanistically related to insulin resistance. Other trends associated with dysglycemia included impaired insulin secretion, reduced GLP-1, and unexpectedly elevated PP.
Details
- Title: Subtitle
- Early mechanisms of diabetes development in pediatric pancreatitis: A pilot study
- Creators
- Maria Graciela Parra Villasmil - University of IowaMelena Bellin - University of MinnesotaCatherina Pinnaro - University of IowaFati Craighead - University of MinnesotaGretchen Cress - University of IowaAliye Uc - University of IowaMark Lowe - Washington University in St. LouisJames S Hodges - University of MinnesotaKatie Larson Ode - University of Iowa, Endocrinology and Diabetes
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric gastroenterology and nutrition, Vol.82(2), pp.549-556
- DOI
- 10.1002/jpn3.70263
- PMID
- 41251022
- NLM abbreviation
- J Pediatr Gastroenterol Nutr
- ISSN
- 0277-2116
- eISSN
- 1536-4801
- Publisher
- Wiley
- Grant note
- UM1TR004403 / the National Center for Advancing Translational Sciences of the National Institutes of Health 5U01DK126300 / the Consortium for the Study of Pancreatitis, Diabetes, and Pancreatic cancer 2P30DK097512 / Center for Diabetes and Metabolic Diseases at Indiana University U01 DK108334 / NIDDK NIH HHS Fraternal Order of Eagles Diabetes Research Center at University of Iowa, and Institute for Diabetes, Obesity and Metabolism
- Language
- English
- Electronic publication date
- 11/18/2025
- Date published
- 02/2026
- Academic Unit
- Endocrinology and Diabetes; Stead Family Department of Pediatrics; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9985033875902771
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