Acute Pancreatitis in Association With Type 2 Diabetes and Antidiabetic Drugs

TLDR

Previous studies show an increased risk of acute pancreatitis in type 2 diabetes, yet data on antidiabetic treatment are limited and further research is warranted. The study aimed to further assess the risk of acute pancreatitis in adult type 2 diabetic patients. A population‑based case‑control analysis nested in a cohort of 85,525 type 2 diabetics and 200,000 diabetes‑free individuals from The Health Improvement Network database followed subjects to identify incident pancreatitis cases. Diabetic patients had a higher incidence of acute pancreatitis (54.0 vs 30.1 per 100,000 person‑years) with an adjusted IRR of 1.77, but the association attenuated to an OR of 1.37 after multivariable adjustment, and insulin therapy was linked to a markedly lower risk (OR 0.35).

Abstract

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.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.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]).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.