Glycemic variability in chronic calcific pancreatitis with diabetes mellitus and its possible determinants

To study glycemic patterns and variability in patients with pancreatic diabetes or type 3c Diabetes mellitus (DM) due to chronic pancreatitis and its subtypes and assess the role of pancreatic enzyme replacement therapy (ERT) in modulating glycemic variability. Patients having type 3c DM due to chro...

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Published in:Diabetes & metabolic syndrome clinical research & reviews 2024-08, Vol.18 (8), p.103100, Article 103100
Main Authors: Chowdhury, Amarta Shankar, Palui, Rajan, Pramanik, Subhodip, Mondal, Sunetra
Format: Article
Language:English
Subjects:
Adult
Biomarkers - analysis
Biomarkers - blood
Blood Glucose - analysis
CGM
Diabetes Mellitus - blood
Enzyme Replacement Therapy
Female
Fibrocalculous pancreatic diabetes
Follow-Up Studies
Glycated Hemoglobin - analysis
Glycemic variability
Humans
Male
Middle Aged
Pancreatic diabetes
Pancreatitis, Chronic - blood
Pancreatitis, Chronic - complications
Prognosis
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Summary:To study glycemic patterns and variability in patients with pancreatic diabetes or type 3c Diabetes mellitus (DM) due to chronic pancreatitis and its subtypes and assess the role of pancreatic enzyme replacement therapy (ERT) in modulating glycemic variability. Patients having type 3c DM due to chronic pancreatitis, and on insulin underwent Flash continuous-glucose-monitoring (CGM) for 14 days. Parameters were compared between patients with fibrocalculous pancreatic diabetes (FCPD) and non-FCPD-chronic calcific pancreatitis (non-FCPD) and between the recipients and non-recipients of pancreatic enzyme-replacement-therapy (ERT). Out of 54 patients with pancreatic diabetes, 35 patients had chronic calcific pancreatitis. They underwent CGM, median HbA1c 9.20 % (77 mmol/mol) and mean Time-In-Range (TIR) being 41.21 % (23.48). Only 5 (15.2 %) patients achieved target TIR>70 % while 16 (48.5 %) patients had high glycemic-variability [Coefficient-of-variation (CV) > 36 %]. Patients with FCPD (n = 14) had higher hypoglycemia-indices like Time-Below-Range (18.92 % vs 8.20 %; p = 0.03) and Low-Blood-Glucose-Index (18.14 % vs 6.04 %; p = 0.02) compared to non-FCPD (n = 21). HbA1c% and hyperglycemic excursions were similar in both groups. Recipients of ERT (n = 20) had lower glycemic-variability [Standard Deviation (SD) 52.15 % vs 68.14 % and CV 32.59 % vs 41.79 %, p 
ISSN:1871-4021
1878-0334
1878-0334
DOI:10.1016/j.dsx.2024.103100