1436-P: High Prevalence of Exocrine Pancreatic Dysfunction in Pediatric Subjects with Diabetes Mellitus

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Introduction & Objective: This study aimed to describe the frequency of exocrine pancreatic disease in youth with diabetes mellitus (DM) to better understand the connection between diseases of the endocrine and exocrine pancreas. Methods: Data was obtained from a single center database of DM patients excluding pre-DM and neonatal DM diagnosis. Patients were categorized as having “Other” DM if they had CFRD, MODY, or drug/chemical induced DM. All patients were then evaluated for exocrine pancreas disease, inclusive of pancreatitis or pancreatic insufficiency. Results: Nine hundred ninety-one patients with DM diagnosis were included and 37/991 (4%) were diagnosed with pancreatic exocrine disease. 11/991 had pancreatitis before DM while 9/991 developed pancreatitis post DM. There were no differences in age, race/ethnicity and sex between DM youth with and without exocrine disease or between those with vs without pancreatitis. Patients with exocrine disease were more likely to have “Other” DM and a lower median hemoglobin A1c at DM diagnosis (6.8% IQR 5.6-9.2% vs 11.2%, 8.9-13.8%; p<0.0001). Excluding those with T1D, those with exocrine disease were more likely to have received insulin therapy (8/37, 22% vs 11/954, 1.2%; p<0.0001) than youth with DM and no exocrine problem. Patients with pancreatitis at any time relative to DM diagnosis were more likely to have “Other” DM and less likely to have T1D (p<0.001), had a lower median A1c (8%, IQR 5.8-9.4% vs 11.2.%, IQR 8.9-13.8%; p=0.0004), and more likely to have received insulin therapy but not have T1D (6/20, 30% vs 11/954, 1.2%; p<0.001). Conclusions: The co-existence of exocrine and endocrine pancreatic disease occurred in 4% of DM patients. Pancreatitis occurred at a rate of 1% in patients with DM, rates higher than the general population (0.01%). Future studies are needed to determine the specific mechanisms involved in the connection between the endocrine and exocrine pancreas in children. Disclosure J.D. Tatum: None. L. Hornung: None. D.A. Elder: Research Support; Dexcom, Inc. A.S. Shah: None. M. Abu-El-Haija: None.

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