PubTransformer

A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Favorable glycemic response after pancreatoduodenectomy in both patients with pancreatic cancer and patients with non-pancreatic cancer.

Abstract Diabetes mellitus (DM) is prevalent in patients with pancreatic cancer and tends to improve after tumor resection. However, the glycemic response of non-pancreatic cancer patients after surgery has not been examined in detail. We aimed to investigate the changes in glucose metabolism in patients with pancreatic cancer or non-pancreatic cancer after pancreatoduodenectomy (PD).We prospectively enrolled 48 patients with pancreatic cancer and 56 patients with non-pancreatic cancer, who underwent PD. Glucose metabolism was assessed with fasting glucose, glycated hemoglobin (HbA1c), plasma C-peptide and insulin, quantitative insulin check index (QUICKI), and a homeostatic model assessment of insulin resistance (HOMA-IR) and β cell (HOMA-β) before surgery and 6 months after surgery. Patients were divided into 2 groups: "improved" and "worsened" postoperative glycemic response, according to the changes in HbA1c and anti-diabetic medication. New-onset DM was defined as diagnosis of DM ≤ 2 years before PD, and cases with DM diagnosis >2 years preceding PD were described as long-standing DM.After PD, insulin resistance (IR), as measured by insulin, HOMA-IR and QUICKI, improved significantly, although C-peptide and HOMA-β decreased. At 6 months after PD, new-onset DM patients showed improved glycemic control in both pancreatic cancer patients (75%) and non-pancreatic cancer patients (63%). Multivariate analysis showed that long-standing DM was a significant predictor for worsening glucose control (odds ratio = 4.01, P = .017).Favorable glycemic control was frequently observed in both pancreatic cancer and non-pancreatic cancer after PD. PD seems to contribute improved glucose control through the decreased IR. New-onset DM showed better glycemic control than long-standing DM.
PMID
Related Publications

Reconstruction after pancreatoduodenectomy. Pancreatojejunostomy or pancreatogastrostomy?.

An appraisal of radical pancreatoduodenectomy based on glucagon secretion.

Functional and morphological changes in pancreatic remnant after pancreaticoduodenectomy.

Metabolic effect of pancreatoduodenectomy: Resolution of diabetes mellitus after surgery.

Resolution of diabetes after pancreaticoduodenectomy in patients with and without pancreatic ductal cell adenocarcinoma.

Authors

Mayor MeshTerms

Pancreaticoduodenectomy

Keywords
Journal Title medicine
Publication Year Start




PMID- 29718860
OWN - NLM
STAT- MEDLINE
DCOM- 20180508
LR  - 20180508
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 18
DP  - 2018 May
TI  - Favorable glycemic response after pancreatoduodenectomy in both patients with
      pancreatic cancer and patients with non-pancreatic cancer.
PG  - e0590
LID - 10.1097/MD.0000000000010590 [doi]
AB  - Diabetes mellitus (DM) is prevalent in patients with pancreatic cancer and tends 
      to improve after tumor resection. However, the glycemic response of
      non-pancreatic cancer patients after surgery has not been examined in detail. We 
      aimed to investigate the changes in glucose metabolism in patients with
      pancreatic cancer or non-pancreatic cancer after pancreatoduodenectomy (PD).We
      prospectively enrolled 48 patients with pancreatic cancer and 56 patients with
      non-pancreatic cancer, who underwent PD. Glucose metabolism was assessed with
      fasting glucose, glycated hemoglobin (HbA1c), plasma C-peptide and insulin,
      quantitative insulin check index (QUICKI), and a homeostatic model assessment of 
      insulin resistance (HOMA-IR) and beta cell (HOMA-beta) before surgery and 6
      months after surgery. Patients were divided into 2 groups: "improved" and
      "worsened" postoperative glycemic response, according to the changes in HbA1c and
      anti-diabetic medication. New-onset DM was defined as diagnosis of DM </= 2 years
      before PD, and cases with DM diagnosis >2 years preceding PD were described as
      long-standing DM.After PD, insulin resistance (IR), as measured by insulin,
      HOMA-IR and QUICKI, improved significantly, although C-peptide and HOMA-beta
      decreased. At 6 months after PD, new-onset DM patients showed improved glycemic
      control in both pancreatic cancer patients (75%) and non-pancreatic cancer
      patients (63%). Multivariate analysis showed that long-standing DM was a
      significant predictor for worsening glucose control (odds ratio = 4.01, P =
      .017).Favorable glycemic control was frequently observed in both pancreatic
      cancer and non-pancreatic cancer after PD. PD seems to contribute improved
      glucose control through the decreased IR. New-onset DM showed better glycemic
      control than long-standing DM.
FAU - Sohn, Seo Young
AU  - Sohn SY
AD  - Department of Internal Medicine, National Cancer Center.
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine,
      Myongji Hospital.
FAU - Lee, Eun Kyung
AU  - Lee EK
AD  - Department of Internal Medicine, National Cancer Center.
FAU - Han, Sung-Sik
AU  - Han SS
AD  - Department of Surgery.
FAU - Lee, You Jin
AU  - Lee YJ
AD  - Department of Internal Medicine, National Cancer Center.
FAU - Hwangbo, Yul
AU  - Hwangbo Y
AD  - Department of Internal Medicine, National Cancer Center.
FAU - Kang, Young Hwa
AU  - Kang YH
AD  - Department of Surgery.
FAU - Lee, Seung Duk
AU  - Lee SD
AD  - Department of Surgery.
FAU - Kim, Seong Hoon
AU  - Kim SH
AD  - Department of Internal Medicine, National Cancer Center.
FAU - Woo, Sang Myung
AU  - Woo SM
AD  - Department of Internal Medicine, National Cancer Center.
FAU - Lee, Woo Jin
AU  - Lee WJ
AD  - Department of Internal Medicine, National Cancer Center.
FAU - Hong, Eun Kyung
AU  - Hong EK
AD  - Department of Pathology, National Cancer Center, Goyang, Gyeonggi, Korea.
FAU - Park, Sang-Jae
AU  - Park SJ
AD  - Department of Surgery.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Blood Glucose)
RN  - 0 (C-Peptide)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Insulin)
SB  - AIM
SB  - IM
MH  - Aged
MH  - Ampulla of Vater/*surgery
MH  - Blood Glucose/*metabolism
MH  - C-Peptide/blood
MH  - Common Bile Duct Neoplasms/blood/*surgery
MH  - Diabetes Mellitus/blood
MH  - Duodenal Neoplasms/blood/*surgery
MH  - Female
MH  - Glycated Hemoglobin A/metabolism
MH  - Humans
MH  - Insulin/blood
MH  - Insulin Resistance
MH  - Male
MH  - Middle Aged
MH  - Pancreatic Neoplasms/blood/*surgery
MH  - *Pancreaticoduodenectomy
EDAT- 2018/05/03 06:00
MHDA- 2018/05/09 06:00
CRDT- 2018/05/03 06:00
PHST- 2018/05/03 06:00 [entrez]
PHST- 2018/05/03 06:00 [pubmed]
PHST- 2018/05/09 06:00 [medline]
AID - 10.1097/MD.0000000000010590 [doi]
AID - 00005792-201805040-00028 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(18):e0590. doi: 10.1097/MD.0000000000010590.