Increased Risk of Acute Pancreatitis Observed in Patients With Type 2 Diabetes

Background: A recent review of the literature documented a considerable increase in pancreatitis incidence in Western Countries. Because many clinical factors frequently associated with diabetes are also risk factors for pancreatitis, it seems likely that the risk of acute pancreatitis in patients with type 2 diabetes would be higher than that of the general population. Objective: To investigate whether adults with type 2 diabetes are at higher risk of acute pancreatitis than adults without diabetes. Methods: This was a retrospective claims database analysis using eligibility, pharmacy and medical claims data from a large US health plan affiliated with i3 Innovus between 1 January 1999 and 31 December 2005. Subjects in the type 2 diabetes cohort had a diagnosis code on a medical claim for type 2 diabetes and a prescription claim for an antidiabetic agent. Subjects in the non-type 2 diabetes cohort had no evidence of diabetes as defined above. Cohorts were matched 1:1 on gender and age categories with 337,067 subjects in each group. The ICD 9 code for acute pancreatitis was used to identify cases. Patients were required to be enrolled in the database for at least 12 months prior to the event of acute pancreatitis with no evidence of pancreatitis during that period. Results: There was a 2.83-fold (95% CI 2.61, 3.06) greater exposure adjusted incidence of acute pancreatitis in patients with type 2 diabetes compared to the cohort without type 2 diabetes. Conclusions: The increasing prevalence of type 2 diabetes and associated risk factors have the potential to increase the incidence of acute pancreatitis in the population. Further studies are needed to confirm this association and ascertain the causal pathways. Clinicians should be aware that compared to the general population, patients with type 2 diabetes may be at higher risk for developing acute pancreatitis.