Hyperglycemia During Acute Pancreatitis and Progression to Early-Onset Diabetes After Recovery: Preliminary Findings From the Diabetes Related to Acute Pancreatitis and Its Mechanisms (DREAM) Study
OBJECTIVE: Hyperglycemia during acute pancreatitis (HDAP) likely reflects both stress hormone responses and pancreatic islet injury, distinguishing it from typical stress-induced hyperglycemia. The aim of this study was to determine the prevalence of HDAP and its prognostic significance for early-onset diabetes following acute pancreatitis (AP). RESEARCH DESIGN AND METHODS: Diabetes Related to Acute Pancreatitis and Its Mechanisms (DREAM) is a prospective multicenter study examining the development of diabetes following AP. This analysis included 395 participants without prior diabetes with an AP episode, focusing on their glucose levels during the event. Two definitions of HDAP were examined: peak glucose >140 mg/dL (HDAP140) and >200 mg/dL (HDAP200). Outpatient glycemic status after recovery (median: 111 days post-AP) was evaluated using fasting glucose, oral glucose tolerance test, and HbA1c. RESULTS: HDAP140 and HDAP200 were present in 37.5% and 7.1% of participants, respectively. Age, race, etiology, and AP severity were significant predictors of HDAP140. Among participants with HDAP140, 14.8% developed early-onset diabetes after AP recovery vs. 1.2% in those without (P = 0.0001). In those with HDAP200, 42.9% developed early-onset diabetes vs. 3.5% in those without (P = 0.0001). The absence of HDAP140 and HDAP200 was associated with negative predictive values of 99% and 97%, respectively, for diabetes. CONCLUSIONS: HDAP can be common in individuals without diabetes and is associated with early-onset diabetes following AP. Individuals without HDAP have a low risk of diabetes short term, while those with HDAP200 are at high risk. Monitoring glycemia during AP can identify individuals best suited for early targeted postdischarge care.
Authors
- Melena D. Bellin (ORCID: https://orcid.org/0000-0002-7324-4837)
- Fahim Abbasi (ORCID: https://orcid.org/0000-0002-3932-8375)
- Kathleen Marie Dungan (ORCID: https://orcid.org/0000-0003-1289-1595)
- Vernon M. Chinchilli (ORCID: https://orcid.org/0000-0001-6488-7809)
- Marina Basina (ORCID: https://orcid.org/0009-0004-3192-6989)
- Brian Thomas Layden (ORCID: https://orcid.org/0000-0003-2176-5654)
- Elham Afghani (ORCID: https://orcid.org/0000-0002-9014-9735)
- EL Fogel
- Jeffrey J. Easler (ORCID: https://orcid.org/0000-0002-3772-2803)
- Anna E. Phillips (ORCID: https://orcid.org/0000-0002-1183-7493)
- Temel Tirkes (ORCID: https://orcid.org/0000-0002-0185-8741)
- Maren R. Laughlin (ORCID: https://orcid.org/0000-0002-1714-2908)
- Ece Mutlu
- James Buxbaum (ORCID: https://orcid.org/0000-0003-0868-5238)
- Frederico G S Toledo
- Ariana Pichardo-Lowden
- Nazia Raja-Khan
- Aynur Unalp-Arida
- Carla Greenbaum
- Anna Casu
- Chris E. Forsmark
- Rajesh Keswani
- John George
- Steven Hughes
- Mustafa Arain
- Venkata S. Akshintala
- Mark O. Goodarzi
- Kirstie Danielsen
- Stephen Pandol
- Richard Pratley
- Dhiraj Yadav
- Guru Trikudanathan
- Cate Speake
- Rita R. Kalyani
- Vikesh K. Singh
- Georgios I. Papachristou
- Carmella Evans-Molina
- Walter G. Park
- Darwin L. Conwell
- Dana Andersen
- Ayesha Siddiqui
- Sandra M. Lord
- Phil A. Hart
- Jose María Salinas Serrano
Institutions
- University of Southern California (US)
- Cedars-Sinai Medical Center (US)
- Pennsylvania State University (US)
- University of Kentucky (US)
- Johns Hopkins University (US)
- University of Pittsburgh (US)
- Johns Hopkins Medicine (US)
- Franciscan Health (US)
- The Ohio State University Wexner Medical Center (US)
- University of Florida (US)
- University of Illinois Chicago (US)
- University of Chicago (US)
- National Institute of Diabetes and Digestive and Kidney Diseases (US)
- Richard L. Roudebush VA Medical Center (US)
- University of Minnesota Medical Center (US)
- Translational Research Institute for Metabolism and Diabetes (US)
- Jesse Brown VA Medical Center (US)
- Stanford Medicine (US)
- Indiana University – Purdue University Indianapolis (US)
- Penn State Milton S. Hershey Medical Center (US)
- Stanford University (US)
Publication Details
- Journal
- Diabetes Care
- Published
- 2026-04-06
- DOI
- https://doi.org/10.2337/dc25-2885
- Primary Topic
- Pancreatitis Pathology and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Institute of Diabetes and Digestive and Kidney Diseases