Background : Impaired glucose metabolism is a widely known complication after pancreatic resection. However, as most reports come from small retrospective cohorts, the precise incidence rate of new-onset diabetes mellitus (DM) after pancreatectomy remains unknown. This population study evaluated the incidence of new-onset DM after pancreatectomy using the Korean Health Insurance Review and Assessment Service (HIRA) database.

Methods : HIRA data was collected from January 2015 to December 2017, and 13026 patients who underwent pancreatectomy were identified. Patients with a known history of diabetes and patients who did not reach five-year follow-up were excluded from analysis.

Results : Among 3671 patients included for analysis, 1858 (50.6%) underwent pancreaticoduodenectomy (PD), 1711 (46.6%) underwent distal pancreatectomy (DP), and 102 (2.8%) underwent total pancreatectomy (TP). In total, 1250 (34.1%) patients developed new-onset DM after pancreatectomy. In the PD group, DM was newly diagnosed in 464 (25.0%) patients; the proportion of new-onset DM was significantly higher in the DP (703/1711, 56.2%) and TP (83/102, 81.4%) groups (P < 0.001). Older age (odds ratio (OR) 1.31, P < 0.001), higher Charlson Comorbidity Index (OR 1.31, P = 0.031), and resection type (DP: OR 2.18, P < 0.001; TP: OR 12.16, P < 0.001) were independent risk factors for new-onset DM in multivariable regression analysis.

Conclusions : DP is associated with a two-fold higher risk of new-onset DM compared to PD. In patients with concurrent risk factors for DM, routine evaluation of blood glucose levels glycated hemoglobin is necessary for early diagnosis and treatment of diabetes.