New-Onset Diabetes Mellitus Following Pancreatic Injury: A Systematic Review.

Introduction: Pancreatic trauma is rare, accounting for only 0.2% of all trauma cases, and reports on long-term endocrine outcomes are scarce. Patients who undergo pancreatic resection may develop diabetes mellitus.

Objectives: To summarize the available literature reporting the incidence of diabetes mellitus (DM) after pancreatic trauma and to evaluate potential influences on the incidence rates.

Patients and methods: We searched in PubMed and Embase for studies published between 1990 and July 2025 that enrolled patients with trauma of the pancreas and reported data on new-onset DM.

Results: Out of 906 identified records, six studies with a total of 297 patients with pancreatic trauma. The overall cumulative incidence of new-onset DM is 5.7% (95% confidence interval [CI]: 3.4%-9.0%). DM developed in 8.2% (95% CI: 4.4%-13.6%) of patients who underwent (partial) pancreatic resection and in 2.9% (95% CI: 0.8%-7.4%) of patients treated nonoperatively. For low-grade injuries, the incidence of DM was 5.5% (95% CI: 2.0%-11.5%) compared to 11.1% (95% CI: 4.9%-20.7%) for high-grade injuries. The time until new-onset diabetes mellitus was detailed in one study with 15 patients.

Conclusion: Based on the available literature, the estimated overall incidence of DM after pancreatic trauma is 5.7%. High-grade pancreatic injury seems to increase the risk of developing new-onset DM, which is possibly influenced by their frequent surgical treatment.