Endocrine Abstracts

Objective: To describe the etiological profile the outcomes of acute pancreatitis (AP) in patients with type 1 diabetes (T1DM).

Patients and Methods: A retrospective descriptive study of 10 T1DM patients who presented at least one episode of AP during their follow-up.

Results: The mean age at diagnosis of T1DM was 19.7±9.3 years, with a female predominance (60%). T1DM was frequently inaugurated by a cardinal syndrome (50%) or spontaneous diabetic ketoacidosis (DKA) (20%). In 10% of patients, T1DM was diagnosed at the time of AP. The episode of AP occurred at a mean age of 26.9±14.9 years. In 57.1% of the cases, the AP wasclassified as stage E. Stages A, B, or C were less commonly reported with a frequency of 14.3%, each. The identified etiologies of AP were autoimmune (20%) or major hypertriglyceridemia (10%). In 70% of the cases, the mechanism of AP remained undetermined. Despite a favorable outcome after the first episode, recurrence of AP is still frequent in T1DM with a rate of 16.7%. Discussion: The pathophysiological mechanism of AP in patients with T1DM remains poorly understood. The consequences of AP on pancreatic tissue previously weakened by autoimmune destruction related to T1DM would be more prominent compared to control subjects. Thus, our work highlights an increased incidence of stage E with more frequent recurrence in this population. Further studies with a large number of subjects are needed to find more precise explanations.

References: 1. Zaher, Fatima Zahra, et al. "Diabetic ketoacidosis revealing a severe hypertriglyceridemia and acute pancreatitis in type 1 diabetes mellitus." Case Reports in Endocrinology 2019 (2019).

2. Nair, Satheesh, Dhiraj Yadav, and C. S. Pitchumoni. "Association of diabetic ketoacidosis and acute pancreatitis: observations in 100 consecutive episodes of DKA." The American journal of gastroenterology 95.10 (2000): 2795-2800.