Natural history of endocrine failure in tropical chronic pancreatitis: A longitudinal follow-up study

Mohan, V and Barman, K K and Rajan, V S and Chari, S T and Deepa, R (2005) Natural history of endocrine failure in tropical chronic pancreatitis: A longitudinal follow-up study. Journal of Gastroenterology and Hepatology, 20 (12). pp. 1927-34. ISSN 0815-9319

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Background and Aims: Diabetes in tropical chronic pancreatitis (TCP), also known as fibrocalculous pancreatic diabetes (FCPD), is frequently seen at diagnosis. The aim of the present study was to determine the natural history of endocrine failure in TCP subjects without diabetes at baseline. Methods: Of 73 TCP subjects without diabetes according to World Health Organization (WHO) criteria at baseline who were seen at an out-patient center, 54 (74.0%) underwent periodic oral glucose tolerance tests on follow up. Another 54 sex-matched, non-diabetic subjects without chronic pancreatitis served as controls. Baseline demographic and clinical characteristics were noted. Results: After a median follow up of 5.0 years in TCP subjects and 7.0 years in controls, 27 of 54 TCP subjects (50%) developed diabetes compared with 14 of 54 controls (25.9%). Of the TCP subjects, those who developed diabetes on follow up were older (31 ± 12 vs 23 ± 11 years; P = 0.013), had a higher body mass index (21.7 ± 4.4 vs 18.2 ± 3.5 kg/m2; P = 0.004), higher 2 h post-load plasma glucose (8.8 ± 1.9 vs 6.7 ± 1.4 mmol/L; P < 0.001) and lower fecal chymotrypsin (2.1 ± 1.2 vs 4.3 ± 2.5 U/g; P < 0.001) at baseline compared with those who did not develop diabetes. The median time for the development of diabetes after diagnosis of TCP was 9.6 years (compared with 14.4 years among controls). Only 2 of 13 TCP subjects (15.4%) who had undergone surgical interventions during the normal glucose tolerance phase developed diabetes during follow up. Conclusions: In TCP, there is progressive deterioration of endocrine pancreatic function, with development of diabetes in 50% of patients upon follow up, suggesting that FCPD is merely a later stage in the course of TCP. Early surgery may prevent the development of diabetes in TCP subjects.

Item Type:Article
Official URL/DOI:
Uncontrolled Keywords:diabetes; fibrocalculous pancreatic diabetes; natural history; tropical chronic pancreatitis.
Subjects:Diabetes > Diabetes Treatment
Diabetology > Pancreatic Diabetes
Divisions:Department of Diabetology
Department of Advanced Research Biochemistry
ID Code:150
Deposited On:31 Oct 2009 16:41
Last Modified:31 Oct 2009 16:41

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