Abstract
Background: New-onset diabetes mellitus (NODM) following distal pancreatectomy (DP) significantly impacts long-term quality of life. This study developed a prediction model for post-DP NODM.
Methods: Retrospective analysis of 159 patients undergoing DP for benign/low-grade malignant lesions (2014-2023). Cox regression identified risk factors incorporated into a scoring system.
Results: Among 130 non-diabetic patients, 26.9 % developed NODM (median 10 months). Five independent predictors: prediabetes (HR 11.02), concomitant splenectomy (HR 2.45), age ≥65 (HR 2.03), BMI ≥25 (HR 1.96), neck/proximal tumor (HR 1.50). The risk scoring system (0-10 points) stratified patients into low-risk (0-2 points), intermediate-risk (3-5 points), and high-risk (6-10 points) categories with significantly different cumulative incidence of NODM at 5 years (4.4 %, 27.9 %, and 87.5 %, respectively). AUC exceeded 0.85 across timepoints.
Conclusions: This simple model enables accurate risk stratification for post-DP NODM, facilitating personalized counseling and tailored surveillance.
Keywords: Diabetes risk stratification; Distal pancreatectomy; New-onset diabetes mellitus; Risk prediction model; Type 3c diabetes.