Increased risk of acute pancreatitis in people with diabetes

A pancreas

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 conlcuded 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]

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Badenoch

Badenoch
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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