Glucose-Lowering Therapy in Patients With Postpancreatitis Diabetes Mellitus: A Nationwide Population-Based Cohort Study

作者：Rikke Viggers, Morten Hasselstrøm Jensen, Henrik Vitus Bering Laursen, Asbjørn Mohr Drewes, Peter Vestergaard, Søren Schou Olesen · 发表于：Diabetes Care · 年份：2021 · DOI：10.2337/dc21-0333 · 被引用次数：45 · 研究领域：Pancreatitis Pathology and Treatment、Diabetes Treatment and Management、Pancreatic and Hepatic Oncology Research

OBJECTIVE Postpancreatitis diabetes mellitus (PPDM) is a type of secondary diabetes that requires special considerations for management. The main objective was to examine prescription patterns of glucose-lowering therapy among adults with PPDM compared with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS In a Danish nationwide population-based cohort study, we identified all individuals with adult-onset diabetes in the period 2000–2018 and categorized them as having type 1 diabetes, type 2 diabetes, or PPDM. We ascertained diabetes incidence rates, clinical and demographic characteristics, and classifications and prescription patterns of glucose-lowering therapy and compared these parameters across diabetes subgroups. RESULTS Among 398,456 adults with new-onset diabetes, 5,879 (1.5%) had PPDM, 9,252 (2.3%) type 1 diabetes, and the remaining type 2 diabetes (96.2%). The incidence rate of PPDM was 7.9 (95% CI 7.7–8.1) per 100,000 person-years versus 12.5 (95% CI 12.2–12.7) for type 1 diabetes (incidence rate ratio 0.6 [95% CI 0.6–0.7]; P < 0.001). A sizeable proportion of patients with PPDM were classified as having type 2 diabetes (44.9%) and prescribed sulfonylureas (25.2%) and incretin-based therapies (18.0%) that can potentially be harmful in PPDM. In contrast, 35.0% of patients never received biguanides, which are associated with a survival benefit in PPDM. Increased insulin requirements were observed for patients with PPDM compared with type 2 diabetes (hazard rat...