P1443 - Prevalence of Pancreatic Insufficiency in Patients with Type 2 Diabetes Mellitus Using Sociodemographic Variables: A Nationwide Analysis in the United States

Jayasree Ravilla, MD¹, Gaurav Mohan, MD¹, Sobaan Taj, MD², Harshavardhan Sanekommu, MD², Siva Naga Srinivas Yarrarapu, MD^1
1Monmouth Medical Center/RWJBH, Long Branch, NJ; ²Hackensack Meridian Jersey Shore University Medical Center, Neptune, NJ

Introduction: It is well known that Pancreatic insufficiency (exocrine function) is common in diabetes (both type 1 and type 2). The exact cause of this association is not well known but there are multiple theories establishing the association. The most common theory explaining this association is lacking trophic factors for the secretion of pancreatic enzymes in insulin insufficiency/resistance and morphological alterations due to diabetic neuropathy. In this study, we have assessed the prevalence of pancreatic insufficiency (CPI) in Type 2 Diabetes Mellitus (T2DM) by using Gender, race, and payer status as variables.

Methods: We curated National Inpatient Sample (2019) for adult hospitalizations with T2 DM. The study sample was stratified by age, sex, race, and payer status using ICD-10 codes. Logistic regression was used to identify the odds of Pancreatic insufficiency with T2 DM. We analyzed the association between CPI and T2DM across different racial and ethnic groups, and several key findings emerged.

Results: Propensity-matched cohorts included 457989 adult T2 DM patients (median age 53.23) admitted on a non-emergency basis among which 5794 patients had chronic exocrine pancreatic insufficiency or chronic pancreatitis. Whites had a slightly increased likelihood of developing CPI in the presence of T2DM (OR 1.16, p=0.03), Blacks exhibited a decreased likelihood (OR 0.59, p = 0.03), Hispanics and Native Americans displayed a similar pattern (OR of 0.48, p = 0.03) & (OR 0.54, p=0.02) respectively, Asian and Pacific Islanders (ASI) had decreased likelihood of CPI (OR 1.23, p=0.3), all were statistically significant except for API (CI -0.76 - 1.98) indicating a wide range of uncertainty. The prevalence in females is slightly lower than in males (OR 0.97, p = 0.67) which has a non-significant difference. Based on the payer status, prevalence among Medicare patients is higher compared to other groups (OR 1.21 p = < 0.05), Medicaid has a lower prevalence (OR 0.73, p = < 0.05), Private including HMO has a lower prevalence but statistically nonsignificant (OR 0.88, p = > 0.05,), Self-pay with lower prevalence, nonsignificant (OR 0.52, p > 0.05) (table)

Discussion: The prevalence of CPI among T2 DM is slightly higher in females and among whites than in other ethnicities. Prevalence seems to be the highest among Medicare patients. Further studies need to be conducted to evaluate the underlying reasons behind the racial disparities in the distribution of pancreatic insufficiency among T2DM.


Disclosures:


Jayasree Ravilla, MD¹, Gaurav Mohan, MD¹, Sobaan Taj, MD², Harshavardhan Sanekommu, MD², Siva Naga Srinivas Yarrarapu, MD¹. P1443 - Prevalence of Pancreatic Insufficiency in Patients with Type 2 Diabetes Mellitus Using Sociodemographic Variables: A Nationwide Analysis in the United States, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.