Increased Risk of Acute Pancreatitis and Biliary Disease Observed in Patients With Type 2 Diabetes

A retrospective cohort study

  1. Rebecca A. Noel, DRPH, MSPH1,
  2. Daniel K. Braun, MD, PHD1,
  3. Ruth E. Patterson, PHD2 and
  4. Gary L. Bloomgren, MD, MBA2
  1. 1Eli Lilly and Company, Indianapolis, Indiana;
  2. 2Amylin Pharmaceuticals, San Diego, California.
  1. Corresponding author: Gary Bloomgren, gary.bloomgren{at}


OBJECTIVE The objective of this study was to assess the risk of acute pancreatitis in patients with type 2 diabetes compared with that in patients without diabetes. We also examined the risk of biliary disease (defined as occurrence of cholelithiasis, acute cholecystitis, or cholecystectomy), which is a major cause of pancreatitis.

RESEARCH DESIGN AND METHODS We conducted a retrospective cohort study using a large, geographically diverse U.S. health care claims database. Eligible patients (≥18 years) were enrolled for at least 12 continuous months (1999–2005), with no incident events of pancreatitis or biliary disease during that 1 year baseline period. ICD-9 codes and prescription data were used to identify patients with type 2 diabetes; ICD-9 codes were also used to identify cases of pancreatitis and biliary disease. Overall, 337,067 patients with type 2 diabetes were matched on age and sex with 337,067 patients without diabetes. Incidence rates of disease and 95% CI were calculated per 100,000 person-years of exposure.

RESULTS The type 2 diabetic cohort had a 2.83-fold (95% CI 2.61–3.06) greater risk of pancreatitis and 1.91-fold (1.84–1.99) greater risk of biliary disease compared with the nondiabetic cohort. Relative to patients of corresponding age without diabetes, younger type 2 diabetic patients had the highest risk of pancreatitis (<45 years: incidence rate ratio [IRR] 5.26 [95% CI 4.31–6.42]; ≥45 years: 2.44 [2.23–2.66]).

CONCLUSIONS These data suggest that patients with type 2 diabetes may have an increased risk of acute pancreatitis and biliary disease.


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    • Received September 24, 2008.
    • Accepted January 17, 2009.
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  1. Diabetes Care vol. 32 no. 5 834-838
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