<p><i>Objective</i>: Postpancreatitis
diabetes mellitus (PPDM) is a type of secondary diabetes that requires special
considerations for management. The main objective was to examine prescription patterns
of glucose-lowering therapy among adults with PPDM compared to type 1 and type
2 diabetes.</p>
<p><i>Research
Design and Methods:</i> In a Danish
nation-wide population-based cohort study we identified all individuals with
adult-onset diabetes mellitus in the period 2000-2018 and categorized them as type
1 diabetes, type 2 diabetes or PPDM. We ascertained diabetes incidence rates, clinical and
demographic characteristics, classifications and prescription patterns of glucose-lowering
therapy and compared these parameters across diabetes subgroups. </p>
<p><i>Results</i><i>:</i> Among 398,456 adults with new-onset diabetes
mellitus, 5,879 (1.5%) had PPDM, 9,252 (2.3%) type 1 diabetes and the remaining type 2 diabetes (96.2%).
The incidence rate of PPDM was 7.9 (95% CI 7.7-8.1) per 100,000 person-years vs.
12.5 (95% CI 12.2-12.7) for type 1 diabetes (incidence-rate-ratio 0.6; 95% CI 0.6-0.7, p<0.001). A sizeable proportion of PPDM
patients were classified as type 2 diabetes (44.9%) and were prescribed sulfonylureas
(25.2%) and incretin-based therapies (18.0%) that can potentially be harmful in
PPDM. In contrast, 35.0% of patients never received biguanides, which are associated
with a survival benefit in PPDM. Increased insulin requirements were observed
for patients with PPDM compared to type 2 diabetes (hazard ratio 3.10; 95% CI 2.96-3.23,
p<0.001) in particular for PPDM associated with chronic pancreatitis (hazard
ratio 4.30; 95% CI 4.01-4.56, p<0.001).</p>
<p><i>Conclusions</i><i>:</i> PPDM is a common type of secondary diabetes in
adults but is often misclassified and treated as type 2 diabetes, although PPDM
requires special considerations for management.</p>