Martyn Stott, Irena Stefanova, Lucy Oldfield, Anthony Evans, James Birch-Ford, Rohith Rao, William Greenhalf, Christopher Halloran, Eithne Costello
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For patients with PDAC, associations between glycaemic status and tumor size, cancer stage, grade, postoperative complications, and outcomes were assessed.</p><p><strong>Results: </strong>Diabetes status was determined for 433 patients. The prevalence of preoperative NOD was higher in PDAC (34.9%; 58/166) compared to ampullary adenocarcinoma (6.3%; 3/48; <i>P</i> < 0.001), cholangiocarcinoma (5.6%; 2/36; <i>P</i> < 0.001), and intraductal papillary mucinous neoplasms (8.9%; 4/45; <i>P</i> = 0.005), but was similar to chronic pancreatitis (30%; 9/30; <i>P</i> = 0.909). For 22/58 (37.9%) PDAC patients with NOD, diabetes was undiagnosed until preoperative testing. In individuals undergoing pancreaticoduodenectomy, delayed gastric emptying (DGE) was more frequently associated with glucose dysregulation than with normoglycaemia (32.8% vs 8.3%; <i>P</i> = 0.004), while overall postoperative pancreatic fistula (POPF) was less frequently associated with glucose dysregulation than with normoglycaemia (4.7% vs 19.4%; <i>P</i> = 0.02).</p><p><strong>Conclusions: </strong>In contrast to PDAC, NOD was infrequently observed in other pancreatic/periampullary tumors. Of clinical importance, in more than one-third of PDAC patients, NOD was undiagnosed until preoperative assessment. Preoperative glucose dysregulation correlated with an increased rate of DGE and a reduced rate of POPF in pancreaticoduodenectomy.</p>","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e584"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185084/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic Cancer.\",\"authors\":\"Martyn Stott, Irena Stefanova, Lucy Oldfield, Anthony Evans, James Birch-Ford, Rohith Rao, William Greenhalf, Christopher Halloran, Eithne Costello\",\"doi\":\"10.1097/AS9.0000000000000584\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To determine the prevalence of new-onset diabetes (NOD) in individuals undergoing pancreatic surgery and to explore the implications of glycaemic status on clinicopathological features and outcomes for patients with pancreatic ductal adenocarcinoma (PDAC).</p><p><strong>Introduction: </strong>PDAC is characterized by a high prevalence of NOD. The prevalence of NOD in individuals undergoing pancreatic surgery for other diseases is less well-documented.</p><p><strong>Methods: </strong>A retrospective analysis of 483 individuals undergoing pancreatic surgery between 2016 and 2020 was undertaken. For patients with PDAC, associations between glycaemic status and tumor size, cancer stage, grade, postoperative complications, and outcomes were assessed.</p><p><strong>Results: </strong>Diabetes status was determined for 433 patients. The prevalence of preoperative NOD was higher in PDAC (34.9%; 58/166) compared to ampullary adenocarcinoma (6.3%; 3/48; <i>P</i> < 0.001), cholangiocarcinoma (5.6%; 2/36; <i>P</i> < 0.001), and intraductal papillary mucinous neoplasms (8.9%; 4/45; <i>P</i> = 0.005), but was similar to chronic pancreatitis (30%; 9/30; <i>P</i> = 0.909). For 22/58 (37.9%) PDAC patients with NOD, diabetes was undiagnosed until preoperative testing. In individuals undergoing pancreaticoduodenectomy, delayed gastric emptying (DGE) was more frequently associated with glucose dysregulation than with normoglycaemia (32.8% vs 8.3%; <i>P</i> = 0.004), while overall postoperative pancreatic fistula (POPF) was less frequently associated with glucose dysregulation than with normoglycaemia (4.7% vs 19.4%; <i>P</i> = 0.02).</p><p><strong>Conclusions: </strong>In contrast to PDAC, NOD was infrequently observed in other pancreatic/periampullary tumors. Of clinical importance, in more than one-third of PDAC patients, NOD was undiagnosed until preoperative assessment. 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引用次数: 0
摘要
目的：了解胰腺手术患者新发糖尿病（NOD）的患病率，并探讨血糖状态对胰腺导管腺癌（PDAC）患者临床病理特征和预后的影响。PDAC的特点是NOD的高患病率。在因其他疾病而接受胰腺手术的患者中，NOD的患病率文献较少。方法：对2016年至2020年接受胰腺手术的483例患者进行回顾性分析。对于PDAC患者，评估血糖状态与肿瘤大小、癌症分期、分级、术后并发症和结局之间的关系。结果：确定了433例患者的糖尿病状态。术前NOD的发生率在PDAC患者中较高(34.9%；58/166)与壶腹腺癌(6.3%；3/48;P < 0.001)，胆管癌(5.6%；2/36;P < 0.001)，导管内乳头状粘液瘤(8.9%；4/45;P = 0.005)，但与慢性胰腺炎相似(30%；9/30;P = 0.909)。在22/58（37.9%）合并NOD的PDAC患者中，直到术前检查才诊断出糖尿病。在接受胰十二指肠切除术的个体中，胃排空延迟（DGE）与葡萄糖失调的关系比与血糖正常的关系更频繁(32.8% vs 8.3%；P = 0.004)，而总体术后胰瘘（POPF）与血糖异常的相关性低于与血糖正常的相关性(4.7% vs 19.4%；P = 0.02)。结论：与PDAC相比，NOD在其他胰腺/壶腹周围肿瘤中很少观察到。具有临床重要性的是，在超过三分之一的PDAC患者中，NOD直到术前评估才被诊断出来。术前血糖失调与胰十二指肠切除术中DGE率升高和POPF率降低相关。
Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic Cancer.
Objective: To determine the prevalence of new-onset diabetes (NOD) in individuals undergoing pancreatic surgery and to explore the implications of glycaemic status on clinicopathological features and outcomes for patients with pancreatic ductal adenocarcinoma (PDAC).
Introduction: PDAC is characterized by a high prevalence of NOD. The prevalence of NOD in individuals undergoing pancreatic surgery for other diseases is less well-documented.
Methods: A retrospective analysis of 483 individuals undergoing pancreatic surgery between 2016 and 2020 was undertaken. For patients with PDAC, associations between glycaemic status and tumor size, cancer stage, grade, postoperative complications, and outcomes were assessed.
Results: Diabetes status was determined for 433 patients. The prevalence of preoperative NOD was higher in PDAC (34.9%; 58/166) compared to ampullary adenocarcinoma (6.3%; 3/48; P < 0.001), cholangiocarcinoma (5.6%; 2/36; P < 0.001), and intraductal papillary mucinous neoplasms (8.9%; 4/45; P = 0.005), but was similar to chronic pancreatitis (30%; 9/30; P = 0.909). For 22/58 (37.9%) PDAC patients with NOD, diabetes was undiagnosed until preoperative testing. In individuals undergoing pancreaticoduodenectomy, delayed gastric emptying (DGE) was more frequently associated with glucose dysregulation than with normoglycaemia (32.8% vs 8.3%; P = 0.004), while overall postoperative pancreatic fistula (POPF) was less frequently associated with glucose dysregulation than with normoglycaemia (4.7% vs 19.4%; P = 0.02).
Conclusions: In contrast to PDAC, NOD was infrequently observed in other pancreatic/periampullary tumors. Of clinical importance, in more than one-third of PDAC patients, NOD was undiagnosed until preoperative assessment. Preoperative glucose dysregulation correlated with an increased rate of DGE and a reduced rate of POPF in pancreaticoduodenectomy.
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