New-Onset Diabetes Mellitus After the First Attack of Acute Pancreatitis: A Systematic Review and Meta-Analysis

New-onset diabetes mellitus (DM) after the first attack of acute pancreatitis (AP) has not been fully elucidated. The study aimed to explore the incidence and time-course of pancreatic endocrine insufficiency in patients with new-onset prediabetes or DM after the first attack of AP.  A comprehensive literature review was conducted by searching four major biomedical journal databases (PubMed, Embase, Cochrane Library, and Web of Science).  We included all prospective clinical studies that investigated the change in the metabolization of glucose after hospital discharge following the first attack of AP.  After quality assessment, data were extracted according to a standard protocol. Because of between-study heterogeneity, data were analyzed by the random-effects method. The inclusion criteria were met by 12 clinical studies, including 766 patients with the first attack of AP. Prediabetes and/or DM was observed in 51% (95% CI: 55% to 63%) of the patients after the first attack of AP. The pooled incidence of prediabetes and DM after AP was 23% (95% CI: 16% to 30%) and 18% (95% CI: 11% to 26%), respectively. The risk of new-onset prediabetes and DM significantly increased in 1 - 3 years (relative risk (RR): 4.00 (95% CI: 1.68 - 9.53)) and 3 - 5 years (RR: 2.12 (95% CI: 1.9 - 3.8)), respectively. New-onset prediabetes and/or DM after the first attack of AP developed in 51% of the patients after hospital discharge and the risk of DM increased more than two folds over three years.