We already know that pancreatitis can lead to diabetes. This systematic review of observational studies looked at whether people with diabetes can subsequently develop pancreatitis.
Clinical question:
In people with diabetes, what is the risk of developing acute pancreatitis?
The reviewers were interested in studies that report new (incident) cases of pancreatitis rather than existing (prevalent) ones.
The evidence:
The reviewers found seven articles, reporting 10,523 new cases of acute pancreatitis. When they pooled the data from these studies they concluded that people with diabetes had a relative risk of 1.92 (95% CI 1.50-2.47) for developing acute pancreatitis compared with the non-diabetic population.
Appraisal hints
Users of this research should consider:
- How good was the search strategy? Could they have missed important studies?
- How do we know that patients didn’t have undiagnosed pancreatitis? With observational research it is hard to determine the direction of causality and detect possible lead-time bias from patients who are at different stages of disease.
- Did the reviewers assess the quality of the individual studies?
- Where did the reviewers get their baseline risk of the non-diabetic population?
- The reviewers acknowledge significant heterogeneity between studies. It may be better to look for individual, high quality observational research that is more specific to your patient population.
Reference:
Xue Y, Sheng Y, Dai H, Cao H, Liu Z, Li Z. Risk of development of acute pancreatitis with pre-existing diabetes: a meta-analysis. Eur J Gastroenterol Hepatol. 2012 Jun 3. [Epub ahead of print]