From Acute Pancreatitis to Diabetes: Risk Factors and Timeline Analysis in a Pediatric Population Study.

OBJECTIVES

This study aimed to identify the risk profile for postpancreatitis diabetes mellitus (PPDM) in children after a single acute pancreatitis (AP) episode and to investigate the association between episode severity and complications, length of stay (LOS), and intensive care unit (ICU) needs.

METHODS

This cross-sectional study used the Pediatric Health Information System database for patients ≤19 years old with index AP admissions (2011-2020). A query (2012-2021) was performed for diabetes mellitus (DM). Patients with prior DM or pancreatic surgery before AP or DM diagnoses were excluded.

RESULTS

Out of 12,822 patients with index AP admissions (median age, 13.4 years; 54% female), 686 (5.4%) developed PPDM, with 320 (2.5%) during and 366 (2.9%) at a later admission. The median time to PPDM was 1.9 months (interquartile range: 0-20.8 months). Patients with PPDM experienced extended LOS, heightened ICU needs, and increased complications such as sepsis, pancreatic necrosis, and cyst formation, along with higher rates of organ dysfunction and comorbidities.

CONCLUSIONS

Children face DM risks during or after AP episodes. Enhanced DM screening and close outpatient follow-up within 3 to 6 months post-discharge are recommended.