Hyperglycemia during acute pancreatitis (AP) may identify individuals at higher risk for developing diabetes soon after recovery, according to findings published in Diabetes Care. Data from the prospective multicenter Diabetes Related to Acute Pancreatitis and Its Mechanisms (DREAM) study show that elevated glucose levels during AP are associated with early-onset diabetes in adults without prior diabetes.

The analysis evaluated 395 adults without preexisting diabetes who were hospitalized with AP. Glycemic exposure during the acute phase was categorized using two peak glucose thresholds: >140 mg/dL (HDAP140) and >200 mg/dL (HDAP200). Demographic and clinical factors, including age, race, underlying cause of AP, and disease severity, were identified as significant correlates of HDAP140. Glycemic status after recovery was assessed at a median of 111 days using fasting plasma glucose, oral glucose tolerance testing, and glycated hemoglobin (HbA1c).

Hyperglycemia, defined by HDAP140 and HDAP200, occurred in 37.5% and 7.1% of cases, respectively. Early-onset diabetes was identified in 14.8% of individuals with HDAP140 compared with 1.2% without (P=0.0001). Among those with HDAP200, the corresponding rates were 42.9% versus 3.5% (P=0.0001). In contrast, the absence of hyperglycemia during AP was associated with high negative predictive values of 99% and 97%.

These findings suggest that in-hospital glucose assessment during AP may help guide postdischarge monitoring strategies in individuals at higher risk for early diabetes.