Diabetes mellitus (DM) may be associated with an increased risk of acute pancreatitis (AP). It is unknown if the underlying aetiology of AP differs between those with and those free of DM. The aim of this study was to determine whether there is any difference in the cause, severity of AP, length of stay, or the occurrence of local versus systemic complications between those with DM versus those free of DM, admitted with AP.
This was a cross-sectional study based on review of medical record of adult patients admitted to a single hospital with acute pancreatitis, 2008 - 2009. Various data was retrieved from the clinical record.
There were 252 admissions for AP during the study period. Diabetes was a co-morbidity in 58 of 252 presentations. Mean duration of diabetes was 9 years (range 0-28 years). The cause of AP did not differ between those with DM or free of DM.
The in-hospital mortality rate was 6.9% for those with diabetes, and 3.1% for those free of diabetes. The length of stay was not different in those with diabetes as compared to those free of diabetes (11.3+/-11.5 days as compared to 9.2+/-12.2 days). Mean IMRE score was higher in those with DM, even if glucose was excluded from the score but there was no difference in the mean CT severity score. The occurrence of systemic inflammatory response syndrome, sepsis or septic shock (SIRS) was more frequent in those with DM (but there was no significant difference in HbA1c between patients with SIRS and patients without SIRS); and in smokers.
Our series demonstrates that presence of DM is associated with increased risk of SIRS in patients admitted with AP. Whether unrestrained inflammation is a mechanism for poorer outcomes amongst other inpatients with DM warrants further investigation.