Risk factors associated with hypoglycemic events after total pancreatectomy: A nationwide multicenter prospective study in Japan

Hironobu Suto, Keiko Kamei, Hiroyuki Kato, Takeyuki Misawa, Michiaki Unno, Hiroyuki Nitta, Sohei Satoi, Yasunari Kawabata, Masayuki Ohtsuka, Toshiki Rikiyama, Takeshi Sudo, Ippei Matsumoto, Tomohiro Hirao, Keiichi Okano, Yasuyuki Suzuki, Naohiro Sata, Shuji Isaji, Masanori Sugiyama, Yoshifumi Takeyama

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The number of total pancreatectomy cases have increased worldwide, expanding the need for new insulin products and high-titer pancrelipases. However, the current data that is focused on hypoglycemic events after a total pancreatectomy from large nationwide series are still lacking. This study is aimed to assess the risk factors associated with hypoglycemic events after a total pancreatectomy. Methods: Data were prospectively collected from 216 consecutive patients who underwent total pancreatectomies between August 2015 and December 2017 from 68 Japanese centers. Of the 216 patients, 166 with a follow-up period of 1 year were analyzed. The risk factors for hypoglycemic events at 6 and 12 months (postoperative months 6 and 12) were investigated based on the results of a nationwide multicenter prospective study. Results: Of the 166 patients, 57 (34%) and 70 (42%) experienced moderate or severe hypoglycemic events or hypoglycemia unawareness on a monthly basis at postoperative months 6 and 12, respectively. Multivariate analysis revealed that body weight loss after surgery ≥0.3 kg and total cholesterol level ≤136 mg/dL at postoperative month 6, and glycated hemoglobin level ≤8.9% and rapid-acting insulin use at postoperative month 12 were independent risk factors for hypoglycemic events after a total pancreatectomy. There were different independent risk factors depending on the postoperative period. Conclusion: Patients with body weight loss after surgery, low total cholesterol level, strict glycemic control, and using rapid-acting insulin should be aware of the occurrence of hypoglycemic events after their total pancreatectomy. In order to prevent hypoglycemic events after a total pancreatectomy, we need to consider optimal nutritional and glycemic control according to the postoperative period.

Original languageEnglish
Pages (from-to)962-967
Number of pages6
JournalSurgery (United States)
Volume172
Issue number3
DOIs
Publication statusPublished - 09-2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery

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