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Acute pancreatitis in association with type 2 diabetes and antidiabetic drugs: a population-based cohort study.

Gonzalez-Perez A, Schlienger RG, Rodríguez LA - Diabetes Care (2010)

Bottom Line: 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]).We also found that insulin use in type 2 diabetes might decrease this risk.Further research is warranted to confirm these associations.

View Article: PubMed Central - PubMed

Affiliation: Centro Español de Investigación Farmacoepidemiológica, Madrid, Spain. agonzalez@ceife.es

ABSTRACT

Objective: 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.

Research design and methods: 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.

Results: 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]).

Conclusions: 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.

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Study cohorts and acute pancreatitis ascertainment.
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Figure 1: Study cohorts and acute pancreatitis ascertainment.

Mentions: We ascertained all patients within the study base with a READ code of diabetes recorded in the database. Based on type-specific READ codes (i.e., those that denote explicitly the type of diabetes), the age at diagnosis, and the lifetime history of antidiabetic pharmacological treatment we were able to classify the initial 92,701 patients with a recorded diagnosis of diabetes into 7,176 (7.74%) patients with type 1 and 85,525 (92.26%) with type 2 diabetes. The latter comprised the type 2 diabetes cohort (Fig. 1).


Acute pancreatitis in association with type 2 diabetes and antidiabetic drugs: a population-based cohort study.

Gonzalez-Perez A, Schlienger RG, Rodríguez LA - Diabetes Care (2010)

Study cohorts and acute pancreatitis ascertainment.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2992194&req=5

Figure 1: Study cohorts and acute pancreatitis ascertainment.
Mentions: We ascertained all patients within the study base with a READ code of diabetes recorded in the database. Based on type-specific READ codes (i.e., those that denote explicitly the type of diabetes), the age at diagnosis, and the lifetime history of antidiabetic pharmacological treatment we were able to classify the initial 92,701 patients with a recorded diagnosis of diabetes into 7,176 (7.74%) patients with type 1 and 85,525 (92.26%) with type 2 diabetes. The latter comprised the type 2 diabetes cohort (Fig. 1).

Bottom Line: 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]).We also found that insulin use in type 2 diabetes might decrease this risk.Further research is warranted to confirm these associations.

View Article: PubMed Central - PubMed

Affiliation: Centro Español de Investigación Farmacoepidemiológica, Madrid, Spain. agonzalez@ceife.es

ABSTRACT

Objective: 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.

Research design and methods: 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.

Results: 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]).

Conclusions: 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.

Show MeSH
Related in: MedlinePlus