A simple five-factor risk model for predicting new-onset diabetes after distal pancreatectomy - 06/12/25
, Ting-Kai Liao a, b, c , Ping-Jui Su b , Chih-Jung Wang a, b , Ying-Jui Chao a, b , Yan-Shen Shan a, b, ⁎ Abstract |
Background |
New-onset diabetes mellitus (NODM) following distal pancreatectomy (DP) significantly impacts long-term quality of life. This study developed a prediction model for post-DP NODM.
Methods |
Retrospective analysis of 159 patients undergoing DP for benign/low-grade malignant lesions (2014–2023). Cox regression identified risk factors incorporated into a scoring system.
Results |
Among 130 non-diabetic patients, 26.9 % developed NODM (median 10 months). Five independent predictors: prediabetes (HR 11.02), concomitant splenectomy (HR 2.45), age ≥65 (HR 2.03), BMI ≥25 (HR 1.96), neck/proximal tumor (HR 1.50). The risk scoring system (0–10 points) stratified patients into low-risk (0–2 points), intermediate-risk (3–5 points), and high-risk (6–10 points) categories with significantly different cumulative incidence of NODM at 5 years (4.4 %, 27.9 %, and 87.5 %, respectively). AUC exceeded 0.85 across timepoints.
Conclusions |
This simple model enables accurate risk stratification for post-DP NODM, facilitating personalized counseling and tailored surveillance.
Le texte complet de cet article est disponible en PDF.Highlights |
What We Found:
• | 26.9 % developed new-onset diabetes mellitus (NODM) following distal pancreatectomy. | ||||||
• | Simple 5-factor scoring system (0–10 points) with excellent discriminative performance (AUC > 0.89). | ||||||
• | Three distinct risk groups with dramatically different 5-year diabetes-free survival:
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• | Clear temporal separation : High-risk patients develop diabetes rapidly (median 7 months) vs low-risk (median 42 months). |
Clinical Value:
• | First procedure-specific prediction tool using routine parameters: age ≥65, BMI ≥25, prediabetes, spleen preservation, tumor location. |
• | Immediate applicability for personalized counseling and risk-adapted surveillance. |
• | Addresses critical gap in precision medicine for pancreatic surgery. |
Keywords : Distal pancreatectomy, New-onset diabetes mellitus, Risk prediction model, Type 3c diabetes, Diabetes risk stratification
Plan
Vol 251
Article 116715- janvier 2026 Retour au numéro
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