Comparing diabetes due to diseases of the exocrine pancreas to type 1 and type 2 diabetes using propensity score matching

Pancreatology. 2020 Jul;20(5):860-866. doi: 10.1016/j.pan.2020.05.023. Epub 2020 Jun 17.

Abstract

Objective: To estimate the prevalence of diabetes due to diseases of the exocrine pancreas (DEP) using data of the multicentre diabetes patient follow-up registry. Moreover, we aimed at comparing individuals with diabetes due to DEP to individuals with type 1 and type 2 diabetes.

Methods: Individuals with DEP, type 1 or type 2 diabetes ≥18 years of age were studied. We aggregated the most recent treatment year per patient and used propensity scores to match diabetes due to DEP to type 1 and type 2 diabetes. Matching was conducted one-to-one with sex, age, diabetes duration, migration background and the German index of socioeconomic deprivation as covariates.

Results: We identified 7,093 (1.6%) individuals with diabetes due to DEP. In the matched cohort DEP-type 1 diabetes we observed a similar daily insulin dose (0.62 IU/kg (95% confidence interval:0.60-0.63), 0.60 IU/kg (0.58-0.62)) and significant differences regarding microvascular (41.0% (39.7-42.2), 45.3% (44.0-46.6)), and macrovascular disease (16.6% (15.7-17.6), 14.7% (13.8-15.6)). HbA1c (8.2% (8.1-8.3), 7.9% (7.8-8.0)), daily insulin dose (0.60 IU/kg (0.58-0.62), 0.56 IU/kg (0.54-0.58)) and event rates of severe hypoglycemia (23.9 events/100 PY (21.4-26.8), (9.5 events/100 PY (8.0-11.2)) were significantly higher in individuals with diabetes due to DEP compared to type 2 diabetes.

Conclusions: Using registry data, rare diabetes types such as diabetes due to DEP can be studied with a significant sample size. Our study identified differences and similarities between adult individuals with DEP related diabetes and type 1 or type 2 diabetes.

Keywords: Diabetes due to diseases of the exocrine pancreas; Propensity score matching; Type 1 diabetes; Type 2 diabetes.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / etiology*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetic Cardiomyopathies / epidemiology
  • Exocrine Pancreatic Insufficiency / complications
  • Exocrine Pancreatic Insufficiency / epidemiology*
  • Female
  • Germany / epidemiology
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemia / epidemiology
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / therapeutic use
  • Insulin / administration & dosage
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Propensity Score
  • Prospective Studies
  • Registries
  • Socioeconomic Factors

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin