Diabetes mellitus as a risk factor for severity and mortality in acute pancreatitis

Abstract

Diabetes mellitus is a lifestyle disease that is one of the most common co-morbidities among patients and can have a substantial impact on the course and case fatality rate of acute disease, including acute pancreatitis. Our primary aim in this study was to analyze the impact of diabetes mellitus type 2 on the severity of acute pancreatitis (AP) and on the hospital mortality of patients with AP. Our secondary aims were 1) to assess the impact of various types of chronic diabetes therapy on the morbidity and lethality of AP and 2) to assess the impacts of decompensation on admission in known diabetics and of acute stress hyperglycemia in non-diabetics on the morbidity and lethality of AP—prospective evaluation of observational data in 248 patients. The hospital mortality rate in patients with diabetes was 5 times higher (17.5% compared to 3.4%, p=0.0004), nd the incidence of persistent organ failure was 6 times higher (40% compared to 6.7%, p<0.0001). Patients without diabetes who had acute stress hyperglycemia >8 mmol/l on admission had a greater incidence of severe AP than those with normal glycemia levels (15.8% compared to 3.3%, p=0.0014). Diabetes mellitus type 2 is connected with a higher incidence of local complications, organ failure and overall hospital mortality rate in patients hospitalized with AP. In non-diabetic patients, acute stress hyperglycemia at the time of admission has a comparable negative impact on the course of AP.