Risk of Mortality and Hospitalization After Post-Pancreatitis Diabetes Mellitus vs Type 2 Diabetes Mellitus: A Population-Based Matched Cohort Study.

OBJECTIVES

To investigate the risk of mortality and hospitalization in individuals with post-pancreatitis diabetes mellitus (PPDM) compared with those with type 2 diabetes mellitus (T2DM).

METHODS

Using nationwide hospital discharge data on pancreatitis and diabetes in New Zealand (n = 231,943), a total of 959 individuals with PPDM were identified. For each individual with PPDM, 10 age- and sex-matched individuals with T2DM were randomly selected. Multivariable Cox regression analysis was conducted, and the risk was expressed as hazard ratio (HR) and 95% confidence interval (CI).

RESULTS

A total of 3,867 deaths occurred among 10,549 study individuals. Individuals with PPDM had all-cause mortality rate at 80.5 (95% CI, 70.3-90.6) per 1,000 person-years, which was higher compared with T2DM individuals (adjusted HR, 1.13 (95% CI, 1.00-1.29); absolute excess risk, 14.8 (95% CI, 4.5-25.2) per 1,000 person-years). Compared with T2DM, PPDM was associated with higher risks of mortality from cancer (adjusted HR, 1.44; 95% CI, 1.13-1.83), infectious disease (adjusted HR, 2.52; 95% CI, 1.69-3.77), and gastrointestinal disease (adjusted HR, 2.56; 95% CI, 1.64-4.01). Individuals with PPDM vs T2DM were also at significantly higher risks of hospitalization for chronic pulmonary disease, moderate to severe renal disease, and infectious disease.

CONCLUSIONS

Individuals with PPDM have higher risk of mortality and hospitalization compared with individuals with T2DM. Guidelines for management of PPDM need to be developed with a view to preventing excess deaths and hospitalizations in individuals with PPDM.