Loading…
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...
Saved in:
| Published in: | Diabetes & metabolic syndrome clinical research & reviews 2024-08, Vol.18 (8), p.103100, Article 103100 |
|---|---|
| Main Authors: | , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | |
|---|---|
| cites | cdi_FETCH-LOGICAL-c235t-7cf0254c4120c150fff87532be5316e0fbac0981934a87a9ddb5b92a4c2b23c13 |
| container_end_page | |
| container_issue | 8 |
| container_start_page | 103100 |
| container_title | Diabetes & metabolic syndrome clinical research & reviews |
| container_volume | 18 |
| creator | Chowdhury, Amarta Shankar Palui, Rajan Pramanik, Subhodip Mondal, Sunetra |
| description | 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 |
| doi_str_mv | 10.1016/j.dsx.2024.103100 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3093171695</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1871402124001619</els_id><sourcerecordid>3093171695</sourcerecordid><originalsourceid>FETCH-LOGICAL-c235t-7cf0254c4120c150fff87532be5316e0fbac0981934a87a9ddb5b92a4c2b23c13</originalsourceid><addsrcrecordid>eNp9kMtuFDEQRS0EIiHwAWwiL9n04LLb022xQlESkCKxgbXlLlcrNerHxPYE5u9xmMCSVT187lX5CvEe1AYUbD_uNjH_2mil2zobUOqFOIe-6xtlTPvyTw9NqzSciTc575Sy1mn3WpwZB61WTp-L3e10RJoZ5WNIHAaeuBwlLxLv07rUNYYJeazNPiyYKBQunOVPLvcyVp4KZTnTVGWHLMMSJZcs92vOPEwkY31PMy9hKfmteDWGKdO753ohftxcf7_60tx9u_169fmuQW1saToclbYttqAVglXjOPadNXoga2BLahwCKteDM23ou-BiHOzgdGhRD9ogmAvx4eS7T-vDgXLxM2esJ4aF1kP2RjkDHWydrSicUEz14kSj3yeeQzp6UP4pYr_zNWL_FLE_RVw1l8_2h2Gm-E_xN9MKfDoBVD_5yJR8RqYFKXIiLD6u_B_73yC3jc0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3093171695</pqid></control><display><type>article</type><title>Glycemic variability in chronic calcific pancreatitis with diabetes mellitus and its possible determinants</title><source>ScienceDirect Freedom Collection 2022-2024</source><creator>Chowdhury, Amarta Shankar ; Palui, Rajan ; Pramanik, Subhodip ; Mondal, Sunetra</creator><creatorcontrib>Chowdhury, Amarta Shankar ; Palui, Rajan ; Pramanik, Subhodip ; Mondal, Sunetra</creatorcontrib><description>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 < 0.05 for both) than non-recipients. ERT-recipients had no serious hypoglycemia within the 14 days. On subgroup analysis, lower glycemic-variability and hypoglycemia with ERT were seen only in FCPD but not in non-FCPD subgroup (50.13 vs 77.91, 30.09 vs 48.36 for SD and CV respectively, p < 0.05).
Patients with type 3c DM due to chronic pancreatitis have high frequency of hyperglycemic and hypoglycemic excursions, with those with FCPD having a particularly higher risk of hypoglycemia and glycemic-variability. Those receiving pancreatic ERT had lesser glycemic variability and hypoglycemia. The small sample size and lack of objective markers of documentation of exocrine pancreatic insufficiency like fecal elastase highlight the need for further larger studies in this field.
•Patients with pancreatic DM/type 3cDM due to chronic pancreatitis have high glycemic variability (GV).•GV & hypoglycemia risk is more in fibrocalculous pancreatopathic DM(FCPD) than non-FCPD chronic pancreatitis.•Patients with type 3c DM receiving pancreatic enzyme-replacement-therapy (PERT) have lower glycemic variability.•Improvement of glycemic variability with is seen mainly in those with FCPD.•Small sample, lack of controls and of objective exocrine-insufficiency like fecal elastase are limitations of the study.</description><identifier>ISSN: 1871-4021</identifier><identifier>ISSN: 1878-0334</identifier><identifier>EISSN: 1878-0334</identifier><identifier>DOI: 10.1016/j.dsx.2024.103100</identifier><identifier>PMID: 39142092</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>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</subject><ispartof>Diabetes & metabolic syndrome clinical research & reviews, 2024-08, Vol.18 (8), p.103100, Article 103100</ispartof><rights>2024 Research Trust of DiabetesIndia (DiabetesIndia) and National Diabetes Obesity and Cholesterol Foundation (N-DOC)</rights><rights>Copyright © 2024 Research Trust of DiabetesIndia (DiabetesIndia) and National Diabetes Obesity and Cholesterol Foundation (N-DOC). Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c235t-7cf0254c4120c150fff87532be5316e0fbac0981934a87a9ddb5b92a4c2b23c13</cites><orcidid>0000-0003-3064-466X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39142092$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chowdhury, Amarta Shankar</creatorcontrib><creatorcontrib>Palui, Rajan</creatorcontrib><creatorcontrib>Pramanik, Subhodip</creatorcontrib><creatorcontrib>Mondal, Sunetra</creatorcontrib><title>Glycemic variability in chronic calcific pancreatitis with diabetes mellitus and its possible determinants</title><title>Diabetes & metabolic syndrome clinical research & reviews</title><addtitle>Diabetes Metab Syndr</addtitle><description>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 < 0.05 for both) than non-recipients. ERT-recipients had no serious hypoglycemia within the 14 days. On subgroup analysis, lower glycemic-variability and hypoglycemia with ERT were seen only in FCPD but not in non-FCPD subgroup (50.13 vs 77.91, 30.09 vs 48.36 for SD and CV respectively, p < 0.05).
Patients with type 3c DM due to chronic pancreatitis have high frequency of hyperglycemic and hypoglycemic excursions, with those with FCPD having a particularly higher risk of hypoglycemia and glycemic-variability. Those receiving pancreatic ERT had lesser glycemic variability and hypoglycemia. The small sample size and lack of objective markers of documentation of exocrine pancreatic insufficiency like fecal elastase highlight the need for further larger studies in this field.
•Patients with pancreatic DM/type 3cDM due to chronic pancreatitis have high glycemic variability (GV).•GV & hypoglycemia risk is more in fibrocalculous pancreatopathic DM(FCPD) than non-FCPD chronic pancreatitis.•Patients with type 3c DM receiving pancreatic enzyme-replacement-therapy (PERT) have lower glycemic variability.•Improvement of glycemic variability with is seen mainly in those with FCPD.•Small sample, lack of controls and of objective exocrine-insufficiency like fecal elastase are limitations of the study.</description><subject>Adult</subject><subject>Biomarkers - analysis</subject><subject>Biomarkers - blood</subject><subject>Blood Glucose - analysis</subject><subject>CGM</subject><subject>Diabetes Mellitus - blood</subject><subject>Enzyme Replacement Therapy</subject><subject>Female</subject><subject>Fibrocalculous pancreatic diabetes</subject><subject>Follow-Up Studies</subject><subject>Glycated Hemoglobin - analysis</subject><subject>Glycemic variability</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pancreatic diabetes</subject><subject>Pancreatitis, Chronic - blood</subject><subject>Pancreatitis, Chronic - complications</subject><subject>Prognosis</subject><issn>1871-4021</issn><issn>1878-0334</issn><issn>1878-0334</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kMtuFDEQRS0EIiHwAWwiL9n04LLb022xQlESkCKxgbXlLlcrNerHxPYE5u9xmMCSVT187lX5CvEe1AYUbD_uNjH_2mil2zobUOqFOIe-6xtlTPvyTw9NqzSciTc575Sy1mn3WpwZB61WTp-L3e10RJoZ5WNIHAaeuBwlLxLv07rUNYYJeazNPiyYKBQunOVPLvcyVp4KZTnTVGWHLMMSJZcs92vOPEwkY31PMy9hKfmteDWGKdO753ohftxcf7_60tx9u_169fmuQW1saToclbYttqAVglXjOPadNXoga2BLahwCKteDM23ou-BiHOzgdGhRD9ogmAvx4eS7T-vDgXLxM2esJ4aF1kP2RjkDHWydrSicUEz14kSj3yeeQzp6UP4pYr_zNWL_FLE_RVw1l8_2h2Gm-E_xN9MKfDoBVD_5yJR8RqYFKXIiLD6u_B_73yC3jc0</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Chowdhury, Amarta Shankar</creator><creator>Palui, Rajan</creator><creator>Pramanik, Subhodip</creator><creator>Mondal, Sunetra</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3064-466X</orcidid></search><sort><creationdate>202408</creationdate><title>Glycemic variability in chronic calcific pancreatitis with diabetes mellitus and its possible determinants</title><author>Chowdhury, Amarta Shankar ; Palui, Rajan ; Pramanik, Subhodip ; Mondal, Sunetra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c235t-7cf0254c4120c150fff87532be5316e0fbac0981934a87a9ddb5b92a4c2b23c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Biomarkers - analysis</topic><topic>Biomarkers - blood</topic><topic>Blood Glucose - analysis</topic><topic>CGM</topic><topic>Diabetes Mellitus - blood</topic><topic>Enzyme Replacement Therapy</topic><topic>Female</topic><topic>Fibrocalculous pancreatic diabetes</topic><topic>Follow-Up Studies</topic><topic>Glycated Hemoglobin - analysis</topic><topic>Glycemic variability</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pancreatic diabetes</topic><topic>Pancreatitis, Chronic - blood</topic><topic>Pancreatitis, Chronic - complications</topic><topic>Prognosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chowdhury, Amarta Shankar</creatorcontrib><creatorcontrib>Palui, Rajan</creatorcontrib><creatorcontrib>Pramanik, Subhodip</creatorcontrib><creatorcontrib>Mondal, Sunetra</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes & metabolic syndrome clinical research & reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chowdhury, Amarta Shankar</au><au>Palui, Rajan</au><au>Pramanik, Subhodip</au><au>Mondal, Sunetra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glycemic variability in chronic calcific pancreatitis with diabetes mellitus and its possible determinants</atitle><jtitle>Diabetes & metabolic syndrome clinical research & reviews</jtitle><addtitle>Diabetes Metab Syndr</addtitle><date>2024-08</date><risdate>2024</risdate><volume>18</volume><issue>8</issue><spage>103100</spage><pages>103100-</pages><artnum>103100</artnum><issn>1871-4021</issn><issn>1878-0334</issn><eissn>1878-0334</eissn><abstract>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 < 0.05 for both) than non-recipients. ERT-recipients had no serious hypoglycemia within the 14 days. On subgroup analysis, lower glycemic-variability and hypoglycemia with ERT were seen only in FCPD but not in non-FCPD subgroup (50.13 vs 77.91, 30.09 vs 48.36 for SD and CV respectively, p < 0.05).
Patients with type 3c DM due to chronic pancreatitis have high frequency of hyperglycemic and hypoglycemic excursions, with those with FCPD having a particularly higher risk of hypoglycemia and glycemic-variability. Those receiving pancreatic ERT had lesser glycemic variability and hypoglycemia. The small sample size and lack of objective markers of documentation of exocrine pancreatic insufficiency like fecal elastase highlight the need for further larger studies in this field.
•Patients with pancreatic DM/type 3cDM due to chronic pancreatitis have high glycemic variability (GV).•GV & hypoglycemia risk is more in fibrocalculous pancreatopathic DM(FCPD) than non-FCPD chronic pancreatitis.•Patients with type 3c DM receiving pancreatic enzyme-replacement-therapy (PERT) have lower glycemic variability.•Improvement of glycemic variability with is seen mainly in those with FCPD.•Small sample, lack of controls and of objective exocrine-insufficiency like fecal elastase are limitations of the study.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>39142092</pmid><doi>10.1016/j.dsx.2024.103100</doi><orcidid>https://orcid.org/0000-0003-3064-466X</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1871-4021 |
| ispartof | Diabetes & metabolic syndrome clinical research & reviews, 2024-08, Vol.18 (8), p.103100, Article 103100 |
| issn | 1871-4021 1878-0334 1878-0334 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3093171695 |
| source | ScienceDirect Freedom Collection 2022-2024 |
| 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 |
| title | Glycemic variability in chronic calcific pancreatitis with diabetes mellitus and its possible determinants |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T10%3A12%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Glycemic%20variability%20in%20chronic%20calcific%20pancreatitis%20with%20diabetes%20mellitus%20and%20its%20possible%20determinants&rft.jtitle=Diabetes%20&%20metabolic%20syndrome%20clinical%20research%20&%20reviews&rft.au=Chowdhury,%20Amarta%20Shankar&rft.date=2024-08&rft.volume=18&rft.issue=8&rft.spage=103100&rft.pages=103100-&rft.artnum=103100&rft.issn=1871-4021&rft.eissn=1878-0334&rft_id=info:doi/10.1016/j.dsx.2024.103100&rft_dat=%3Cproquest_cross%3E3093171695%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c235t-7cf0254c4120c150fff87532be5316e0fbac0981934a87a9ddb5b92a4c2b23c13%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3093171695&rft_id=info:pmid/39142092&rfr_iscdi=true |