Chronic pancreatitis and pancreatogenic type 3c diabetes risk: a systematic review and meta-analysis

Mengtay Makashova, Amin Tamadon, Yerlan Bazargaliyev, Khatimya I. Kudabayeva, Р Н Космуратова, Nadiar Maratovich Mussin, Ramazon Safarzoda Sharoffidin

Therapeutic Advances in Endocrinology and Metabolism, 2026

Полный текст Открытый доступ: Gold Метаданные (CSL-JSON)
DOI 10.1177/20420188261469942
Достоверность данных 70 средняя
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Аннотация

Background: Chronic pancreatitis (CP) progressively destroys pancreatic parenchyma and predisposes patients to pancreatogenic type 3c diabetes mellitus (T3cDM). Objectives: We conducted a systematic review and meta-analysis of cohort studies enrolling adults with clinically and/or instrumentally confirmed CP and no pre-existing diabetes at baseline. Design: Systematic review and meta-analysis of cohort studies. Data sources and methods: Scopus, Web of Science Core Collection, and PubMed were searched from inception to August 2025. Random-effects models estimated pooled incidence of new-onset diabetes and the proportion requiring insulin. Prespecified subgroup analyses were stratified by follow-up duration (<60 months, 60–120 months, >120 months). Meta-regression explored demographic, behavioral, and clinical moderators. Results: Nineteen studies met the inclusion criteria and contributed to the primary meta-analysis of incident diabetes after CP. The pooled incidence of diabetes was 30% (95% CI: 27–34; I ² = 94.8%), with a prediction interval of 15%–49%. Exploratory follow-up-stratified analysis suggested a time-dependent increase: 18% (95% CI: 14–22) at <60 months, 25% (95% CI: 15–35) at 60–120 months, and 44% (95% CI: 24–66) at >120 months ( p for subgroup differences = 0.0184). Among patients who developed diabetes, 59% (95% CI: 46–71; 7 studies; I ² = 91.7%) required insulin therapy. Meta-regression did not identify statistically significant study-level moderators, although pancreatic calcification showed a non-significant positive trend. Conclusion: CP is associated with a substantial and time-dependent incidence of diabetes; however, the pooled estimates should be interpreted cautiously because the included studies were observational and highly heterogeneous. These findings support long-term glycemic monitoring and careful classification of pancreatogenic diabetes in patients with CP, while optimal screening intervals and treatment timing require further prospective evidence. Trial registration: PROSPERO CRD420251136931.