Glycemic Control after Total Pancreatectomy for Intraductal Papillary Mucinous Neoplasm : An Exploratory Study

Abstract EN

Background.

Glycemic control following total pancreatectomy (TP) has been thought to be difficult to manage.

Diffuse intraductal papillary mucinous neoplasm (IPMN) is a potentially curable precursor to pancreatic adenocarcinoma, best treated by TP.

Objective.

Compare glycemic control in patients undergoing TP for IPMN to patients with type 1 diabetes mellitus (DM).

Design/Setting.

Retrospective cohort.

Outcome Measure.

Hemoglobin A1C(HbA1C) at 6, 12, 18, and 24 months after TP.

In the control group, baseline was defined as 6 months prior to the first HbA1c measure.

Results.

Mean HgbA1C at each point of interest was similar between TP and type I DM patients (6 months (7.5% versus 7.7%, P=0.52), 12 months (7.3% versus 8.0%, P=0.081), 18 months (7.7% and 7.6%, P=0.64), and at 24 months (7.3% versus 7.8%, P=0.10)).

Seven TP patients (50%) experienced a hypoglycemic event compared to 65 type 1 DM patients (65%, P=0.38).

Limitations.

Small number of TP patients, retrospective design, lack of long-termfollowup.

Conclusion.

This suggests that glycemic control following TP for IPMNcan be well managed, similar to type 1 DM patients.

Fear of DM following TP for IPMN should not preclude surgery when TP is indicated.