Childhood Acute Pancreatitis and Diabetes in Adulthood

What is it about?

Diabetes occurs when the pancreas is unable to secrete sufficient insulin to maintain normal glycemia. Aute pancreatitis may be accompanied by transient hyperglycemia, but resolves in most patients without sequelae. Nevertheless, a sequelae of β-cell damage that is accompanied with an increased risk for diabetes later in life may be underappreciated. In children and adolescents, there is scarce evidence linking acute pancreatitis with incident diabetes. In an Israeli nationwide population-based study, we observed that a history of childhood resolved acute pancreatitis with normal pancreatic function in late adolescence, doubled the risk for incident type 2 diabetes, especially at young adulthood.

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Photo by Jesse Bowser on Unsplash

Photo by Jesse Bowser on Unsplash

Why is it important?

Residual damage following acute inflammatory insult may result with reduced activity of the β-cells to support normal glucose levels. Thus, it could be that inflammation of the exocrine pancreas in pancreatitis collaterally damage β-cells of the endocrine islets, resulting in a reduced islet mass. The fact that the acute insult seems to be clinically resolved, as judged by standard clinical measures, may not necessarily reflect absence of some residual damage to β-cell mass, especially in the first years after injury. We suggest that history of pancreatitis should be considered as a risk factor, especially during young adulthood. This may be of special importance in individuals with other risk factors. Patients with history of acute pancreatitis may require a tighter follow-up and possibly a more aggressive control of other risk factors. Maintaining normal weight is likely central, as most patients with history of pancreatitis were overweight or obese at the time of their diabetes diagnosis. We focus our efforts on understanding the critical risk factors for early onset type 2 diabetes, or diabetes onset before age 40 years, as the prevalence of diabetes in this age group has increased disproportionately. There is compelling evidence that incidence of diabetes at such a young age is not only associated with higher financial burden, but also with higher rates of diabetes complications and worse clinical outcomes.

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