ArticleBMC surgery2025
Glucose metabolism after distal pancreatectomy - deterioration of beta cell function becomes noticeable at an early stage: a retrospective cohort study.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDistal pancreatectomy (DP) can worsen pancreatic endocrine function. Effects on glucose metabolism and underlying mechanisms after DP remains a topic of significant interest and not yet fully understood. This study aimed to examine the impact of DP on blood glucose homeostasis with a particular focus on metabolic outcomes and development of postoperative diabetes.
methodsConsidered were all patients who underwent DP between 01/2010 and 09/2021 and participated simultaneously in extended blood glucose monitoring with a 12 months follow-up. Blood samples were analyzed for markers of pancreatic endocrine function both fasting and after an oral glucose tolerance test preoperatively and 3 and 12 months after DP.
resultsIncluded patients (n = 69) were preoperatively categorized into three groups according to American Diabetes Association (ADA) criteria: 17 patients (24.6%) were normoglycemic (NG), 22 (31.9%) had prediabetes (impaired fasting glucose / impaired glucose tolerance - IFG/IGT) and 30 (43.5%) had diabetes mellitus (DM). In the NG subgroup, beta-cell function (HOMA2%B - updated homeostasis model assessment) significantly decreased from 117.4% (101.1-135%) to 66.9% (49.7-102.1%) at 12 months postoperatively (p < 0.05). Insulin sensitivity (HOMA2%S) significantly increased from 48.2% (33.4-66.9%) to 63.5% (49.8-86%) at 12 months postoperatively (p < 0.05). In the IFG/IGT subgroup, there was a non-significant trend of decreased HOMA2%B and increased HOMA2%S postoperatively. Postoperatively, 11.8% of NG patients and 60% of prediabetic patients developed DM.
conclusionDP already leads to significant changes in glucose metabolism within a 12 month follow-up period. Patients with preoperative prediabetes are particularly at high risk of developing postoperative DM. Therefore, the indication for DP should be critically evaluated, especially in cases with a relative indication for surgery. If possible parenchymal sparing surgical options should be contemplated.
trial registrationNot applicable.
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