Characteristics of patients who developed glucose intolerance in the early period after partial pancreatectomy.

BACKGROUND: New-onset diabetes mellitus (DM) often develops after partial pancreatectomy. Little is known regarding how soon patients develop glucose intolerance after partial pancreatectomy. We investigated the incidence of and factors contributing to the development of glucose intolerance during hospitalization after partial pancreatectomy. PATIENTS AND METHODS: We retrospectively analyzed the cases of 38 patients with normal glucose tolerance pre-surgery who underwent a partial pancreatectomy (pancreaticoduodenectomy, n = 23; distal pancreatectomy, n = 15). The patients' glucose tolerance and insulin secretory/sensitivity values were determined by a normal meal tolerance test (NMTT) within 2 months post-surgery during their hospitalization.
RESULTS: The post-surgery NMTT values revealed that 11 (28.9%) patients developed new-onset impaired glucose tolerance (the IGT group); the other 27 (71.1%) patients maintained normal glucose tolerance (the NGT group). The pre-operative hemoglobin A1c (HbA1c) levels were significantly higher in the IGT group (5.84%) versus the NGT group (5.58%, p = 0.034). There were no significant between-group differences in age, sex ratio, body mass index, the ratio of operative procedure (either pancreaticoduodenectomy or distal pancreatectomy), or post-operative insulin secretory values including the fasting/postprandial C-peptide index. The IGT group showed significantly higher insulin resistance assessed by the homeostasis model assessment of insulin resistance (HOMA-IR) versus the NGT group (1.52 ± 0.67 vs. 0.65 ± 0.42, p < 0.001).
CONCLUSION: After undergoing a partial pancreatectomy, approximately 30% of the patients developed glucose intolerance during the hospitalized period. Our findings indicate that pre-operative HbA1c and post-operative HOMA-IR values can be associated with developing glucose intolerance just after partial pancreatectomy. © The Japan Diabetes Society 2020.