OBJECTIVE: The aim of this study is to determine the prevalence of diabetes mellitus (DM) in patients with intraductal papillary mucinous neoplasm of the pancreas (IPMN) and compare rates of new/progressive DM between IPMN patients undergoing pancreatectomy versus observation. METHODS: Patients diagnosed with IPMN were identified from institutional databases, divided into two groups based on treatment type, pancreatectomy versus clinical observation, and subsequently evaluated. Standard demographic and clinicopathologic variables, fasting glucose, diabetic status, and pancreatic volume data, were obtained and compared between groups. RESULTS: One hundred thirty-four IPMN patients were identified; 103 (77 %) underwent pancreatectomy and 31 (23 %) were observed. Baseline DM rate was 18 % (24/134). This was not different between groups [17 % (17/103) resected vs. 23 % (7/31) observed, p = 0.51]. Median follow-up was 53 months and new/progressive DM occurred in 37 (28 %) patients with no difference between groups [29 (28 %) resected vs. 8 (26 %) observed, p = 0.74]. Among resected patients, degree of dysplasia was associated with increase risk of new/progressive DM [moderate dysplasia OR 5.76 (1.24-26.79) and severe dysplasia OR 9.43 (1.54-57.74), p = 0.04], while procedure type and remnant volume were not. CONCLUSIONS: The incidence and prevalence of DM among patients with IPMN was high and did not differ between resected and observed groups. Degree of dysplasia, not the amount of resected pancreas, was associated with increased risk of DM, suggesting that the presence or development of DM may be a marker of malignant progression. Confirmatory studies are required.
OBJECTIVE: The aim of this study is to determine the prevalence of diabetes mellitus (DM) in patients with intraductal papillary mucinous neoplasm of the pancreas (IPMN) and compare rates of new/progressive DM between IPMNpatients undergoing pancreatectomy versus observation. METHODS:Patients diagnosed with IPMN were identified from institutional databases, divided into two groups based on treatment type, pancreatectomy versus clinical observation, and subsequently evaluated. Standard demographic and clinicopathologic variables, fasting glucose, diabetic status, and pancreatic volume data, were obtained and compared between groups. RESULTS: One hundred thirty-four IPMNpatients were identified; 103 (77 %) underwent pancreatectomy and 31 (23 %) were observed. Baseline DM rate was 18 % (24/134). This was not different between groups [17 % (17/103) resected vs. 23 % (7/31) observed, p = 0.51]. Median follow-up was 53 months and new/progressive DM occurred in 37 (28 %) patients with no difference between groups [29 (28 %) resected vs. 8 (26 %) observed, p = 0.74]. Among resected patients, degree of dysplasia was associated with increase risk of new/progressive DM [moderate dysplasia OR 5.76 (1.24-26.79) and severe dysplasia OR 9.43 (1.54-57.74), p = 0.04], while procedure type and remnant volume were not. CONCLUSIONS: The incidence and prevalence of DM among patients with IPMN was high and did not differ between resected and observed groups. Degree of dysplasia, not the amount of resected pancreas, was associated with increased risk of DM, suggesting that the presence or development of DM may be a marker of malignant progression. Confirmatory studies are required.
Authors: Stephen R Grobmyer; Fredric M Pieracci; Peter J Allen; Murray F Brennan; David P Jaques Journal: J Am Coll Surg Date: 2007-03 Impact factor: 6.113
Authors: Ralph H Hruban; Kyoichi Takaori; Marcia Canto; Elliot K Fishman; Kurtis Campbell; Kieran Brune; Scott E Kern; Michael Goggins Journal: J Hepatobiliary Pancreat Surg Date: 2007-05-29
Authors: Michael D'Angelica; Murray F Brennan; Arief A Suriawinata; David Klimstra; Kevin C Conlon Journal: Ann Surg Date: 2004-03 Impact factor: 12.969
Authors: Stefano Crippa; Claudio Bassi; Andrew L Warshaw; Massimo Falconi; Stefano Partelli; Sarah P Thayer; Paolo Pederzoli; Carlos Fernández-del Castillo Journal: Ann Surg Date: 2007-07 Impact factor: 12.969
Authors: Thomas Schnelldorfer; Michael G Sarr; David M Nagorney; Lizhi Zhang; Thomas C Smyrk; Rui Qin; Suresh T Chari; Michael B Farnell Journal: Arch Surg Date: 2008-07
Authors: Jason T Wiseman; Jeffery Chakedis; Eliza W Beal; Anghela Paredes; Amy McElhany; Andrew Fang; Andrei Manilchuk; Christopher Ellison; George Van Buren; Timothy M Pawlik; Carl R Schmidt; William E Fisher; Mary Dillhoff Journal: J Gastrointest Surg Date: 2021-05-04 Impact factor: 3.452
Authors: Jeremy Sharib; Laura Esserman; Eugene J Koay; Anirban Maitra; Yu Shen; Kimberly S Kirkwood; Elissa M Ozanne Journal: Surgery Date: 2020-07-29 Impact factor: 3.982