Clinical characteristics, management and psychological outcomes of patients with diabetes secondary to chronic pancreatitis

IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Practical Diabetes Pub Date : 2024-05-01 DOI:10.1002/pdi.2501

Philip C Johnston, Aaron Herron, Mark Davies, Mark Taylor, Glynis Magee, Ailish Nugent, Judith Garrity, Ian Wallace, Judith Thompson

{"title":"Clinical characteristics, management and psychological outcomes of patients with diabetes secondary to chronic pancreatitis","authors":"Philip C Johnston, Aaron Herron, Mark Davies, Mark Taylor, Glynis Magee, Ailish Nugent, Judith Garrity, Ian Wallace, Judith Thompson","doi":"10.1002/pdi.2501","DOIUrl":null,"url":null,"abstract":"Aims: To determine the clinical characteristics, management, rates of complications and psychological outcomes of patients with diabetes mellitus secondary to chronic pancreatitis (DMsCP) referred to the Belfast Pancreatic Diabetes Clinic.Methods: Clinical and laboratory data were obtained from online health care records (NIECR). Psychological outcomes and a service‐based questionnaire were performed.Results: Baseline characteristics (n=63 patients [male: 41, female: 22]) at initial referral included: mean age 56.2 years (range 19–84); mean duration of chronic pancreatitis 10.7 years (range 1–40); mean duration of diabetes 7.2 years (range 1–40). Previous pancreatic surgery was performed in 19% (12/63) of patients. Initial mean HbA1c was 82mmol/mol (range 41–189); mean HbA1c at six and 12 months follow‐up was 69.9mmol/mol and 70.6mmol/mol, respectively. Rates of microvascular complications included: retinopathy (background and pre‐proliferative) 16%; microalbuminuria 17%; peripheral neuropathy 14%, with no foot ulceration/amputation occurring. Macrovascular disease occurred in 24% of patients. Sixteen (25%) had missed at least one outpatient diabetes appointment over the preceding year. Quality of life (QoL) as measured by the PANQOLI was low with a mean total score of 64.9/103; 59% (16/27) of the service cohort also breached clinical cut‐offs for the presence of both anxiety (GAD‐7) and depression (PHQ‐9).Summary: DMsCP in our cohort was characterised by significant micro‐ and macrovascular complications, sub‐optimal glycaemic control, reduced clinic attendance and impaired QoL as well as a significant component of anxiety and depression. The optimal care for these patients should consist of a collaborative approach that best meets their complex and multifaceted needs. Copyright © 2024 John Wiley & Sons.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Practical Diabetes","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/pdi.2501","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Aims: To determine the clinical characteristics, management, rates of complications and psychological outcomes of patients with diabetes mellitus secondary to chronic pancreatitis (DMsCP) referred to the Belfast Pancreatic Diabetes Clinic.Methods: Clinical and laboratory data were obtained from online health care records (NIECR). Psychological outcomes and a service‐based questionnaire were performed.Results: Baseline characteristics (n=63 patients [male: 41, female: 22]) at initial referral included: mean age 56.2 years (range 19–84); mean duration of chronic pancreatitis 10.7 years (range 1–40); mean duration of diabetes 7.2 years (range 1–40). Previous pancreatic surgery was performed in 19% (12/63) of patients. Initial mean HbA1c was 82mmol/mol (range 41–189); mean HbA1c at six and 12 months follow‐up was 69.9mmol/mol and 70.6mmol/mol, respectively. Rates of microvascular complications included: retinopathy (background and pre‐proliferative) 16%; microalbuminuria 17%; peripheral neuropathy 14%, with no foot ulceration/amputation occurring. Macrovascular disease occurred in 24% of patients. Sixteen (25%) had missed at least one outpatient diabetes appointment over the preceding year. Quality of life (QoL) as measured by the PANQOLI was low with a mean total score of 64.9/103; 59% (16/27) of the service cohort also breached clinical cut‐offs for the presence of both anxiety (GAD‐7) and depression (PHQ‐9).Summary: DMsCP in our cohort was characterised by significant micro‐ and macrovascular complications, sub‐optimal glycaemic control, reduced clinic attendance and impaired QoL as well as a significant component of anxiety and depression. The optimal care for these patients should consist of a collaborative approach that best meets their complex and multifaceted needs. Copyright © 2024 John Wiley & Sons.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

慢性胰腺炎继发糖尿病患者的临床特征、管理和心理结果

目的：确定转诊至贝尔法斯特胰腺糖尿病诊所的慢性胰腺炎继发性糖尿病（DMsCP）患者的临床特征、管理、并发症发生率和心理结果：临床和实验室数据来自在线医疗记录（NIECR）。结果：基线特征（63 名患者）（n=63）和心理结果（n=63）：首次转诊时的基线特征（63 名患者，男性 41 名，女性 22 名）包括：平均年龄 56.2 岁（19-84 岁不等）；慢性胰腺炎平均病程 10.7 年（1-40 年不等）；糖尿病平均病程 7.2 年（1-40 年不等）。19%的患者（12/63）曾接受过胰腺手术。初始平均 HbA1c 为 82mmol/mol（范围 41-189）；随访 6 个月和 12 个月时的平均 HbA1c 分别为 69.9mmol/mol 和 70.6mmol/mol。微血管并发症的发生率包括：视网膜病变（背景和增殖前）16%；微量白蛋白尿 17%；周围神经病变 14%，没有发生足部溃疡/截肢。24%的患者患有大血管疾病。16名患者（25%）在过去一年中至少错过了一次糖尿病门诊预约。根据 PANQOLI 测量，患者的生活质量（QoL）较低，平均总分为 64.9/103；59%（16/27）的患者还超过了焦虑症（GAD-7）和抑郁症（PHQ-9）的临床临界值。对这些患者的最佳治疗应包括一种协作方法，以最好地满足他们复杂和多方面的需求。版权所有 © 2024 约翰威利父子公司。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Practical Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

1.10

自引率

16.70%

发文量

期刊介绍： Practical Diabetes concerns itself with all aspects of the worldwide clinical science and practice of diabetes medicine. The journal recognises the importance of each member of the healthcare team in the delivery of diabetes care, and reflects this diversity of professional interest in its editorial contents. The Editors welcome original papers, case reports, practice points, audit articles and letters on any aspect of clinical diabetes care from any part of the world. The journal also publishes commissioned leaders, review articles and educational and training series, for which an honorarium normally is paid. All articles submitted to Practical Diabetes are independently peer reviewed. They must not have been published or be under submission currently elsewhere. Enquiries from prospective authors are welcomed and the Editors will be pleased, if asked, to advise on preparation and submission of articles. All articles and enquiries should be directed to the Editors at the publishing address below. The journal is published nine times a year, and currently the average waiting time for acceptance of articles is eight weeks, and for subsequent publication sixteen weeks. Practical Diabetes is independent of any commercial or vested interest.