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Diabetic control after total pancreatectomy.

P Jethwa1, M Sodergren, A Lala

  • 1The Liver Unit, Queen Elizabeth Hospital, University of Birmingham, Edgbaston, Birmingham B15 2TH, United Kingdom. paras.jj@virgin.net

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|March 11, 2006
PubMed
Summary

Diabetes after total pancreatectomy can achieve good glycaemic control, comparable to type 1 diabetes. Patients often report excellent daily performance and diabetic management post-surgery.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Diabetes following total pancreatectomy is often termed 'brittle'.
  • Previous studies primarily focused on outcomes after resection for pancreatitis.
  • This study aimed to assess glycaemic control in patients undergoing total pancreatectomy for both benign and malignant conditions.

Purpose of the Study:

  • To evaluate glycaemic control in patients who have undergone total pancreatectomy.
  • To compare outcomes in patients resected for benign versus malignant diseases.
  • To compare glycaemic control against a matched type 1 diabetic population.

Main Methods:

  • Retrospective analysis of patients undergoing total pancreatectomy (1989-2003).
  • Data collection via case notes, general practitioners, and telephonic consultation.

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  • Comparison with a matched cohort of type 1 diabetic patients.

    • Main Results:

    • Forty-seven patients were identified; 33 had detailed follow-up.
    • No significant difference in median HbA1c between the study group (8.2%) and controls (8.1%).
    • Majority reported excellent or good diabetic control and daily performance; poorer subjective control noted after pancreatitis resection.

    Conclusions:

    • Diabetes after total pancreatectomy does not invariably lead to poor glycaemic control.
    • Biochemical control is often equivalent to that of type 1 diabetes.
    • Most patients achieve satisfactory diabetic management and daily functioning post-total pancreatectomy.