Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic Cancer
Objective:. To determine the prevalence of new-onset diabetes (NOD) in individuals undergoing pancreatic surgery and to explore the implications of glycaemic status on clinicopathological features and outcomes for patients with pancreatic ductal adenocarcinoma (PDAC). Introduction:. PDAC is characte...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health
2025-06-01
|
| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000584 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850067546039910400 |
|---|---|
| author | Martyn Stott, MBBS Irena Stefanova, MBBS Lucy Oldfield, PhD Anthony Evans, PhD James Birch-Ford, MBBS Rohith Rao, MBBS William Greenhalf, PhD Christopher Halloran, MD Eithne Costello, PhD |
| author_facet | Martyn Stott, MBBS Irena Stefanova, MBBS Lucy Oldfield, PhD Anthony Evans, PhD James Birch-Ford, MBBS Rohith Rao, MBBS William Greenhalf, PhD Christopher Halloran, MD Eithne Costello, PhD |
| author_sort | Martyn Stott, MBBS |
| collection | DOAJ |
| description | Objective:. To determine the prevalence of new-onset diabetes (NOD) in individuals undergoing pancreatic surgery and to explore the implications of glycaemic status on clinicopathological features and outcomes for patients with pancreatic ductal adenocarcinoma (PDAC).
Introduction:. PDAC is characterized by a high prevalence of NOD. The prevalence of NOD in individuals undergoing pancreatic surgery for other diseases is less well-documented.
Methods:. A retrospective analysis of 483 individuals undergoing pancreatic surgery between 2016 and 2020 was undertaken. For patients with PDAC, associations between glycaemic status and tumor size, cancer stage, grade, postoperative complications, and outcomes were assessed.
Results:. Diabetes status was determined for 433 patients. The prevalence of preoperative NOD was higher in PDAC (34.9%; 58/166) compared to ampullary adenocarcinoma (6.3%; 3/48; P < 0.001), cholangiocarcinoma (5.6%; 2/36; P < 0.001), and intraductal papillary mucinous neoplasms (8.9%; 4/45; P = 0.005), but was similar to chronic pancreatitis (30%; 9/30; P = 0.909). For 22/58 (37.9%) PDAC patients with NOD, diabetes was undiagnosed until preoperative testing. In individuals undergoing pancreaticoduodenectomy, delayed gastric emptying (DGE) was more frequently associated with glucose dysregulation than with normoglycaemia (32.8% vs 8.3%; P = 0.004), while overall postoperative pancreatic fistula (POPF) was less frequently associated with glucose dysregulation than with normoglycaemia (4.7% vs 19.4%; P = 0.02).
Conclusions:. In contrast to PDAC, NOD was infrequently observed in other pancreatic/periampullary tumors. Of clinical importance, in more than one-third of PDAC patients, NOD was undiagnosed until preoperative assessment. Preoperative glucose dysregulation correlated with an increased rate of DGE and a reduced rate of POPF in pancreaticoduodenectomy. |
| format | Article |
| id | doaj-art-cae282798ff74672b080587bd1a14469 |
| institution | DOAJ |
| issn | 2691-3593 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-cae282798ff74672b080587bd1a144692025-08-20T02:48:17ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932025-06-0162e58410.1097/AS9.0000000000000584202506000-00018Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic CancerMartyn Stott, MBBS0Irena Stefanova, MBBS1Lucy Oldfield, PhD2Anthony Evans, PhD3James Birch-Ford, MBBS4Rohith Rao, MBBS5William Greenhalf, PhD6Christopher Halloran, MD7Eithne Costello, PhD8From the * Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UKFrom the * Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UKFrom the * Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UKFrom the * Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UKFrom the * Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UKFrom the * Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UKFrom the * Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UKFrom the * Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UKFrom the * Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UKObjective:. To determine the prevalence of new-onset diabetes (NOD) in individuals undergoing pancreatic surgery and to explore the implications of glycaemic status on clinicopathological features and outcomes for patients with pancreatic ductal adenocarcinoma (PDAC). Introduction:. PDAC is characterized by a high prevalence of NOD. The prevalence of NOD in individuals undergoing pancreatic surgery for other diseases is less well-documented. Methods:. A retrospective analysis of 483 individuals undergoing pancreatic surgery between 2016 and 2020 was undertaken. For patients with PDAC, associations between glycaemic status and tumor size, cancer stage, grade, postoperative complications, and outcomes were assessed. Results:. Diabetes status was determined for 433 patients. The prevalence of preoperative NOD was higher in PDAC (34.9%; 58/166) compared to ampullary adenocarcinoma (6.3%; 3/48; P < 0.001), cholangiocarcinoma (5.6%; 2/36; P < 0.001), and intraductal papillary mucinous neoplasms (8.9%; 4/45; P = 0.005), but was similar to chronic pancreatitis (30%; 9/30; P = 0.909). For 22/58 (37.9%) PDAC patients with NOD, diabetes was undiagnosed until preoperative testing. In individuals undergoing pancreaticoduodenectomy, delayed gastric emptying (DGE) was more frequently associated with glucose dysregulation than with normoglycaemia (32.8% vs 8.3%; P = 0.004), while overall postoperative pancreatic fistula (POPF) was less frequently associated with glucose dysregulation than with normoglycaemia (4.7% vs 19.4%; P = 0.02). Conclusions:. In contrast to PDAC, NOD was infrequently observed in other pancreatic/periampullary tumors. Of clinical importance, in more than one-third of PDAC patients, NOD was undiagnosed until preoperative assessment. Preoperative glucose dysregulation correlated with an increased rate of DGE and a reduced rate of POPF in pancreaticoduodenectomy.http://journals.lww.com/10.1097/AS9.0000000000000584 |
| spellingShingle | Martyn Stott, MBBS Irena Stefanova, MBBS Lucy Oldfield, PhD Anthony Evans, PhD James Birch-Ford, MBBS Rohith Rao, MBBS William Greenhalf, PhD Christopher Halloran, MD Eithne Costello, PhD Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic Cancer Annals of Surgery Open |
| title | Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic Cancer |
| title_full | Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic Cancer |
| title_fullStr | Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic Cancer |
| title_full_unstemmed | Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic Cancer |
| title_short | Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic Cancer |
| title_sort | prevalence of new onset diabetes in patients undergoing pancreatic surgery and the association of glucose dysregulation with complications in pancreatic cancer |
| url | http://journals.lww.com/10.1097/AS9.0000000000000584 |
| work_keys_str_mv | AT martynstottmbbs prevalenceofnewonsetdiabetesinpatientsundergoingpancreaticsurgeryandtheassociationofglucosedysregulationwithcomplicationsinpancreaticcancer AT irenastefanovambbs prevalenceofnewonsetdiabetesinpatientsundergoingpancreaticsurgeryandtheassociationofglucosedysregulationwithcomplicationsinpancreaticcancer AT lucyoldfieldphd prevalenceofnewonsetdiabetesinpatientsundergoingpancreaticsurgeryandtheassociationofglucosedysregulationwithcomplicationsinpancreaticcancer AT anthonyevansphd prevalenceofnewonsetdiabetesinpatientsundergoingpancreaticsurgeryandtheassociationofglucosedysregulationwithcomplicationsinpancreaticcancer AT jamesbirchfordmbbs prevalenceofnewonsetdiabetesinpatientsundergoingpancreaticsurgeryandtheassociationofglucosedysregulationwithcomplicationsinpancreaticcancer AT rohithraombbs prevalenceofnewonsetdiabetesinpatientsundergoingpancreaticsurgeryandtheassociationofglucosedysregulationwithcomplicationsinpancreaticcancer AT williamgreenhalfphd prevalenceofnewonsetdiabetesinpatientsundergoingpancreaticsurgeryandtheassociationofglucosedysregulationwithcomplicationsinpancreaticcancer AT christopherhalloranmd prevalenceofnewonsetdiabetesinpatientsundergoingpancreaticsurgeryandtheassociationofglucosedysregulationwithcomplicationsinpancreaticcancer AT eithnecostellophd prevalenceofnewonsetdiabetesinpatientsundergoingpancreaticsurgeryandtheassociationofglucosedysregulationwithcomplicationsinpancreaticcancer |