Introduction and Objective: Pancreatogenic diabetes (T3cDM) results from pancreatic exocrine dysfunction leading to endocrine insufficiency. Although linked to acute/chronic pancreatitis (AP/CP) and pancreatic cancer (PC), the incidence and predictors of diabetes after these conditions require clarification. This study determines the pooled incidence of new-onset diabetes following AP, CP, and PC and identifies disease-specific risk factors.Methods: We systematically reviewed studies reporting new-onset diabetes after AP, CP, or PC. Incidence was pooled with random-effects models. Subgroup analyses were conducted by disease type. Risk factors were synthesized using odds ratios (ORs) and Hedges’ g.Results: The pooled incidence of new-onset diabetes was 18.0% (95% CI: 15.8-20.4%) after AP, 28.2% (95% CI: 24.2-32.5%) after CP, and 16.7% (95% CI: 14.4-19.2%) for PCRD (defined as diabetes within 2 years before PC diagnosis). Risk factors were distinct across diseases: AP risk was driven by severe acute injury (organ failure [OR=3.20], necrotizing pancreatitis [OR=3.04]), specific etiology (hypertriglyceridemic pancreatitis [OR=2.17]), and baseline metabolic factors (high BMI [g=0.47], hypertriglyceridemia [g=0.58], chronic kidney disease [OR=2.10]). For CP, the highest-risk condition, predictors included structural damage (pancreatic calcification [OR=2.53], biliary stricture [OR=2.16]), lifestyle factors (smoking [OR=1.62], alcohol use [OR=1.69]), and male sex (OR=1.44). In PC, significant predictors were advanced age (g=0.27, p<0.01) and higher baseline BMI (g=0.24, p<0.01), whereas male sex (OR=1.10) and smoking (OR=0.86) showed no significant association.Conclusion: Pancreatogenic diabetes risk is highest in chronic pancreatitis and varies by etiology. Disease-specific risk profiles enable precise stratification, guiding tailored monitoring strategies based on incidence and modifiable predictors.
Y. Du: None. X. Wang: None. L. Li: None.
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