NEW YORK (Reuters Health) – Patients with type 2 diabetes have an almost three-fold higher risk of acute pancreatitis and two-fold greater risk of biliary disease compared with sex- and age-matched controls without diabetes, according to a case-control study in the May issue of Diabetes Care.

“The increased risk of pancreatitis for patients with type 2 diabetes reported here, combined with the increasing prevalence of diabetes and the associated risk factors, may be contributing to a meaningful increase in the incidence of acute pancreatitis in the US,” Dr. Gary L. Bloomgren, at Amylin Pharmaceuticals in San Diego, California, and co-authors suggest.

The research team used a nationwide managed care claims database that included nearly a million adults enrolled for at least 12 continuous months between 1999 and 2005 during which time they experienced no incident events of pancreatitis or biliary disease. There were 337,067 patients with type 2 diabetes and a similar number of controls.

For pancreatitis, the incidence rate per 100,000 patient years was 422 among the diabetics and 149 among the nondiabetics (incidence rate ratio = 2.83).

For biliary disease, which included cholelithiasis, acute cholecystitis, and cholecystectomy, the corresponding incidence rates were 1411 and 737 (IRR = 1.91).

For both conditions, younger diabetics had the highest risk relative to controls. Thus, for acute pancreatitis, patients aged between 18 and 30 years old had an IRR of 7.75 vs 1.64 among those who were 65 years or older. For biliary disease, The IRR for the younger age group was 3.77 compared with 1.50 for the older group.

This study was supported by Amylin Pharmaceuticals and Eli Lilly, producers of the diabetes drug exenatide (Byetta), which has been associated with spontaneous reports of acute pancreatitis, which the authors say “prompted this investigation.”

Reference:
Diabetes Care 2009;32:834-838.