Glucose metabolism after distal pancreatectomy - deterioration of beta cell function becomes noticeable at an early stage: a retrospective cohort study
Abstract Background Distal pancreatectomy (DP) can worsen pancreatic endocrine function. Effects on glucose metabolism and underlying mechanisms after DP remains a topic of significant interest and not yet fully understood. This study aimed to examine the impact of DP on blood glucose homeostasis wi...
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BMC
2025-04-01
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| Online Access: | https://doi.org/10.1186/s12893-025-02867-z |
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| author | Mikheil Kalandarishvili Florian Oehme Olga Radulova-Mauersberger Nicole Kipke Michele Solimena Christian Teske Nicolas Mibelli Jürgen Weitz Marius Distler Sebastian Hempel |
| author_facet | Mikheil Kalandarishvili Florian Oehme Olga Radulova-Mauersberger Nicole Kipke Michele Solimena Christian Teske Nicolas Mibelli Jürgen Weitz Marius Distler Sebastian Hempel |
| author_sort | Mikheil Kalandarishvili |
| collection | DOAJ |
| description | Abstract Background Distal pancreatectomy (DP) can worsen pancreatic endocrine function. Effects on glucose metabolism and underlying mechanisms after DP remains a topic of significant interest and not yet fully understood. This study aimed to examine the impact of DP on blood glucose homeostasis with a particular focus on metabolic outcomes and development of postoperative diabetes. Methods Considered were all patients who underwent DP between 01/2010 and 09/2021 and participated simultaneously in extended blood glucose monitoring with a 12 months follow-up. Blood samples were analyzed for markers of pancreatic endocrine function both fasting and after an oral glucose tolerance test preoperatively and 3 and 12 months after DP. Results Included patients (n = 69) were preoperatively categorized into three groups according to American Diabetes Association (ADA) criteria: 17 patients (24.6%) were normoglycemic (NG), 22 (31.9%) had prediabetes (impaired fasting glucose / impaired glucose tolerance – IFG/IGT) and 30 (43.5%) had diabetes mellitus (DM). In the NG subgroup, beta-cell function (HOMA2%B - updated homeostasis model assessment) significantly decreased from 117.4% (101.1–135%) to 66.9% (49.7–102.1%) at 12 months postoperatively (p < 0.05). Insulin sensitivity (HOMA2%S) significantly increased from 48.2% (33.4–66.9%) to 63.5% (49.8–86%) at 12 months postoperatively (p < 0.05). In the IFG/IGT subgroup, there was a non-significant trend of decreased HOMA2%B and increased HOMA2%S postoperatively. Postoperatively, 11.8% of NG patients and 60% of prediabetic patients developed DM. Conclusion DP already leads to significant changes in glucose metabolism within a 12 month follow-up period. Patients with preoperative prediabetes are particularly at high risk of developing postoperative DM. Therefore, the indication for DP should be critically evaluated, especially in cases with a relative indication for surgery. If possible parenchymal sparing surgical options should be contemplated. Trial registration Not applicable. |
| format | Article |
| id | doaj-art-bca4af624d2f4831abee1d6fb6260ddd |
| institution | OA Journals |
| issn | 1471-2482 |
| language | English |
| publishDate | 2025-04-01 |
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| series | BMC Surgery |
| spelling | doaj-art-bca4af624d2f4831abee1d6fb6260ddd2025-08-20T02:11:59ZengBMCBMC Surgery1471-24822025-04-0125111110.1186/s12893-025-02867-zGlucose metabolism after distal pancreatectomy - deterioration of beta cell function becomes noticeable at an early stage: a retrospective cohort studyMikheil Kalandarishvili0Florian Oehme1Olga Radulova-Mauersberger2Nicole Kipke3Michele Solimena4Christian Teske5Nicolas Mibelli6Jürgen Weitz7Marius Distler8Sebastian Hempel9Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenPaul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenAbstract Background Distal pancreatectomy (DP) can worsen pancreatic endocrine function. Effects on glucose metabolism and underlying mechanisms after DP remains a topic of significant interest and not yet fully understood. This study aimed to examine the impact of DP on blood glucose homeostasis with a particular focus on metabolic outcomes and development of postoperative diabetes. Methods Considered were all patients who underwent DP between 01/2010 and 09/2021 and participated simultaneously in extended blood glucose monitoring with a 12 months follow-up. Blood samples were analyzed for markers of pancreatic endocrine function both fasting and after an oral glucose tolerance test preoperatively and 3 and 12 months after DP. Results Included patients (n = 69) were preoperatively categorized into three groups according to American Diabetes Association (ADA) criteria: 17 patients (24.6%) were normoglycemic (NG), 22 (31.9%) had prediabetes (impaired fasting glucose / impaired glucose tolerance – IFG/IGT) and 30 (43.5%) had diabetes mellitus (DM). In the NG subgroup, beta-cell function (HOMA2%B - updated homeostasis model assessment) significantly decreased from 117.4% (101.1–135%) to 66.9% (49.7–102.1%) at 12 months postoperatively (p < 0.05). Insulin sensitivity (HOMA2%S) significantly increased from 48.2% (33.4–66.9%) to 63.5% (49.8–86%) at 12 months postoperatively (p < 0.05). In the IFG/IGT subgroup, there was a non-significant trend of decreased HOMA2%B and increased HOMA2%S postoperatively. Postoperatively, 11.8% of NG patients and 60% of prediabetic patients developed DM. Conclusion DP already leads to significant changes in glucose metabolism within a 12 month follow-up period. Patients with preoperative prediabetes are particularly at high risk of developing postoperative DM. Therefore, the indication for DP should be critically evaluated, especially in cases with a relative indication for surgery. If possible parenchymal sparing surgical options should be contemplated. Trial registration Not applicable.https://doi.org/10.1186/s12893-025-02867-zDistal pancreatectomyBlood glucose homeostasisPostoperative hyperglycemiaNew-onset diabetes mellitusPancreatogenic diabetes |
| spellingShingle | Mikheil Kalandarishvili Florian Oehme Olga Radulova-Mauersberger Nicole Kipke Michele Solimena Christian Teske Nicolas Mibelli Jürgen Weitz Marius Distler Sebastian Hempel Glucose metabolism after distal pancreatectomy - deterioration of beta cell function becomes noticeable at an early stage: a retrospective cohort study BMC Surgery Distal pancreatectomy Blood glucose homeostasis Postoperative hyperglycemia New-onset diabetes mellitus Pancreatogenic diabetes |
| title | Glucose metabolism after distal pancreatectomy - deterioration of beta cell function becomes noticeable at an early stage: a retrospective cohort study |
| title_full | Glucose metabolism after distal pancreatectomy - deterioration of beta cell function becomes noticeable at an early stage: a retrospective cohort study |
| title_fullStr | Glucose metabolism after distal pancreatectomy - deterioration of beta cell function becomes noticeable at an early stage: a retrospective cohort study |
| title_full_unstemmed | Glucose metabolism after distal pancreatectomy - deterioration of beta cell function becomes noticeable at an early stage: a retrospective cohort study |
| title_short | Glucose metabolism after distal pancreatectomy - deterioration of beta cell function becomes noticeable at an early stage: a retrospective cohort study |
| title_sort | glucose metabolism after distal pancreatectomy deterioration of beta cell function becomes noticeable at an early stage a retrospective cohort study |
| topic | Distal pancreatectomy Blood glucose homeostasis Postoperative hyperglycemia New-onset diabetes mellitus Pancreatogenic diabetes |
| url | https://doi.org/10.1186/s12893-025-02867-z |
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