Smoking and prior acute pancreatitis attacks are risk factors for poor glycemic control in patients with post-chronic pancreatitis diabetes

1. Smoking and prior acute pancreatitis attacks independently predict poor glycaemic control in patients with post-chronic pancreatitis diabetes (PPDM-C).

2. Early intervention and smoking cessation should be prioritized to improve metabolic outcomes in this population.

Evidence Rating Level: 2 (Good) 

Among patients with chronic pancreatitis, the prevalence of PPDM-C is extremely high, necessitating a more comprehensive understanding of this disorder. This retrospective cross-sectional study examined 302 patients with PPDM-C to identify predictors of poor glycemic control. Using data from 2018–2023, the authors defined poor glycemic status as HbA1c >7% and stratified patients based on whether they received diabetes treatment. Multivariate logistic regression and receiver operating characteristic analyses revealed that smoking and a history of acute pancreatitis (AP) attacks were independent risk factors for poor glycemic control in both treated and untreated groups. The association between smoking and poor control was dose-dependent, with heavy smokers showing up to a tenfold increased risk. Overall, 58% of participants had poor glycemic status, and untreated patients fared worse than those on therapy. Structural pancreatic damage and alcohol use were not independently linked to glycemic outcomes. These findings highlight the need for early detection, aggressive risk factor modification, and tailored glycemic management in this high-risk population.

Click here to read this study in BMJ Open

Image: PD

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