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World J Gastroenterol. Jul 28, 2023; 29(28): 4405-4415
Published online Jul 28, 2023. doi: 10.3748/wjg.v29.i28.4405
Post-acute pancreatitis diabetes: A complication waiting for more recognition and understanding
Diego García-Compeán, Alan R Jiménez-Rodríguez, Juan M Muñoz-Ayala, José A González-González, Héctor J Maldonado-Garza, Jesús Z Villarreal-Pérez
Diego García-Compeán, Alan R Jiménez-Rodríguez, Juan M Muñoz-Ayala, José A González-González, Héctor J Maldonado-Garza, Department of Gastroenterology, Autonomous University of Nuevo León, Monterrey 64700, Nuevo León, Mexico
Jesús Z Villarreal-Pérez, Department of Endocrinology, Autonomous University of Nuevo León, Monterrey 64700, Nuevo León, Mexico
Author contributions: García-Compeán D, Jiménez-Rodríguez AR, and Muñoz-Ayala JM made a bibliographic research and wrote sections of the manuscript; Villarreal-Pérez JZ, González-González JA, and Maldonado-Garza HJ critically reviewed the manuscript; García-Compeán D conceived and coordinated the whole project.
Conflict-of-interest statement: The authors declare no conflict of interest in the preparation of this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Diego García-Compeán, MD, MSc, Adjunct Professor, Department of Gastroenterology, Autonomous University of Nuevo León, Madero y Gonzalitos s/n Col Mitras Centro, Monterrey 64700, Nuevo León, Mexico. digarciacompean@prodigy.net.mx
Received: June 1, 2023
Peer-review started: June 1, 2023
First decision: June 16, 2023
Revised: June 22, 2023
Accepted: July 11, 2023
Article in press: July 11, 2023
Published online: July 28, 2023
Processing time: 54 Days and 18.1 Hours
Abstract

Post-acute pancreatitis diabetes (PAPD) is the second most common type of diabetes below type 2 diabetes mellitus. Due to the boom in research on this entity carried out during the last decade, its recognition has increased. However, much of the medical community still does not recognize it as a medium and long-term complication of acute pancreatitis (AP). Recent prospective cohort studies show that its incidence is about 23% globally and 34.5% in patients with severe AP. With the overall increase in the incidence of AP this complication will be certainly seen more frequently. Due to its high morbidity, mortality and difficult control, early detection and treatment are essential. However, its risk factors and pathophysiological mechanisms are not clearly defined. Its diagnosis should be made excluding pre-existing diabetes and applying the criteria of the American Diabetes Association after 90 d of resolution of one or more AP episodes. This review will show the evidence published so far on the incidence and prevalence, risk factors, possible pathophysiological mechanisms, clinical outcomes, clinical characteristics and preventive and corrective management of PAPD. Some important gaps needing to be clarified in forthcoming studies will also be discussed.

Keywords: Acute pancreatitis; Diabetes mellitus; Chronic pancreatitis; Post-pancreatitis diabetes; Pancreatogenic diabetes

Core Tip: Post-acute pancreatitis diabetes (PAPD) is the second most common type of diabetes below type II diabetes mellitus. Its incidence is about 23% globally and 34.5% in severe acute pancreatitis (AP). With the overall increase in the incidence of AP this complication will also increase. Due to its high mortality, early detection and treatment are essential. Diagnosis should be made excluding pre-existing diabetes and applying the criteria of the American Diabetes Association after 90 d of resolution of AP episodes. This review will show published evidence on the incidence, risk factors, pathophysiology, clinical outcomes, clinical characteristics and preventive and corrective management of PAPD.