Diabetes post pancreatitis: experiencia clínica en 40 casos / Diabetes secondary to pancreatitis: clinical experience in 40 cases

RESUMO

The clinical features and evolution of 40 patients with diabetes mellitus secondary to chronic pancreatitis were reviewed and compared with 40 insulin dependent diabetics matched for the disease duration. The diagnosis of pancreatitis was confirmed by the existence of pancreatic calcifications, surgery or autopsy and was associated to alcoholism in males and biliary diseases in females. Diabetes appeared as a mean, 3 years after the diagnosis of pancreatitis. Ninety percent of subjects required insulin and, in males, these requirements were higher than their matched controls. Episodes of ketoacidosis were less frequent than in insulin dependent patients (8 vs 48 percent p<0.001) and pulmonary tuberculosis had a higher prevalence (22.5 vs 5 percent p<0.01). Nephropathy was observed with equal frequency in both groups but the incidence of retinopathy was higher on postpancreatic diabetics (38 vs 20 percent p<0.01). It is concluded that the features of diabetes secondary to chronic pancreatitis are similar to those of insulin dependent diabetes, with some quantitative differences