Study Details Predictors of Diabetes in People with Chronic Pancreatitis

Mark Goodarzi, MD, PhD

An analysis of data from the PROCEED study is providing clinicians with new insights into the impact of different factors and clinical characteristics on risk of developing diabetes among patients with chronic pancreatitis.

Results of the study suggest, among patients with chronic pancreatitis, men were more than twice as likely as women to develop diabetes, people with overweight or obesity were nearly 3 times more likely to develop diabetes as their counterparts with normal weight, and those at an older age faced an increased likelihood of developing diabetes, with odds increasing 3% per year of a person’s life in the study.

“What we're hoping to do with this information is to build prediction models that clinicians can use to manage patients with chronic pancreatitis who don’t yet have diabetes,” said lead investigator Mark Goodarzi, MD, PhD, the Eris M. Field Chair in Diabetes Research at Cedars-Sinai Medical Center, in a statement from Cedars-Sinai. “We can look at these factors and say, ‘This patient is at high risk of developing diabetes within X number of years,’ allowing us to identify patients we need to follow closely to help prevent diabetes.”

With chronic pancreatitis associated with excess damage to the pancreas and subsequent diabetes diagnoses in previous research, Goodarzi and a team of colleagues from Cedars-Sinai sought to develop a clinical prediction model for diabetes in chronic pancreatitis. To do so, investigators designed their research endeavor as a using information from adults enrolled in the Prospective Evaluation of Chronic Pancreatitis for Epidemiologic and Translational Studies (PROCEED) study.

From the PROCEED study, investigators obtained information related to 645 people with pancreatitis. Among this cohort, 276 had diabetes. Using data related to clinical characteristics of these individuals, investigators conducted univariable and multivariable regression analyses to identify potential risk factors for development of diabetes. Investigators noted model performance was assessed by area under the receiver operating characteristic curve (AUROC) analysis, and accuracy was evaluated by cross validation. Investigators also pointed out exploratory analyses were stratified according to timing of the development of diabetes relative to diagnosis of chronic pancreatitis.

In the aforementioned release, Cedars-Sinai highlighted 5 specific risk factors of note associated with increased risk of developing diabetes:

• Men were more likely than women to develop diabetes (OR, 2.42 [95% CI, 1.64-3.60]; P <.001).
• People with overweight or obese were more likely than people with a normal weight to develop diabetes (OR, 2.76 [95% CI, 1.86-4.14]; P <.001).
• People who identified as Black (OR, 2.53 [95% CI, 1.26-5.09]; P=.009), Hispanic (OR, 3.16, 1.00-10.74]; P=.055) and other (OR, 2.33 [95% CI, 1.23-4.46]; P=.01) were more likely than those who identified as White to develop diabetes.
• Smokers were more likely thannonsmokers to develop diabetes (OR, 2.08 [95% CI, 1.19-3.66]).
• Older people were more likely to develop diabetes; the odds of developing the disease increased 3% per year of a person’s life (OR, 1.03 [95% CI, 1.01-1.05]; P <.001).

“Known risk factors for Type 2 diabetes as well as pancreas-specific features such as calcium deposits in the pancreas or shrinkage of the pancreas predicted who developed diabetes among persons with pancreatitis,” said Christie Jeon, ScD, a research associate professor in the Department of Medicine and research scientist at the Samuel Oschin Cancer Institute at Cedars-Sinai, in the aforementioned statement.

This study, “Development of a Clinical Prediction Model for Diabetes in Chronic Pancreatitis: The PREDICT3c Study,” was published in Diabetes Care.