Type 2 Diabetes Increases Severity but Not Mortality in Acute Pancreatitis: A Large Multicenter Analysis.

BACKGROUND/AIMS: Type 2 diabetes mellitus (T2DM) is increasingly recognized as a factor that may influence the course of acute pancreatitis (AP), but its independent associations with severity and mortality remain uncertain. The study investigated the independent association of preexisting T2DM with disease severity and in-hospital mortality in individuals with AP. MATERIALS AND METHODS: This multicenter retrospective cohort study included 4458 patients with AP from 3 medical centers. Patients were categorized into T2DM (n = 711) and non-T2DM groups (n = 3747). Demographic and clinical data were collected. Multivariable logistic regression analysis was used to evaluate the associations of T2DM with disease severity and in-hospital mortality after adjustment for potential confounders. Stabilized inverse probability of treatment weighting (sIPTW) analyses were performed to assess the robustness of the results. RESULTS: Compared with the non-T2DM group, the T2DM group was older and had a significantly higher proportion of males, and higher prevalences of hypertension and chronic kidney disease. In multivariable analysis, T2DM was independently associated with increased disease severity (OR = 1.42, 95% CI: 1.19-1.69) but not with in-hospital mortality (OR = 1.14, 95% CI: 0.61-2.02). The sIPTW analysis yielded consistent findings, with T2DM remaining independently associated with increased disease severity but not with in-hospital mortality. CONCLUSION: Preexisting T2DM is independently associated with increased disease severity in patients with AP but not with in-hospital mortality.