New-Onset Diabetes Mellitus Following Pancreatic Injury: A Systematic Review.

Abstract

Pancreatic trauma is rare, accounting for only 0.2% of all trauma cases, and reports on long-term endocrine outcomes are scarce. Patients who undergo pancreatic resection may develop diabetes mellitus. To summarize the available literature reporting the incidence of diabetes mellitus (DM) after pancreatic trauma and to evaluate potential influences on the incidence rates. We searched in PubMed and Embase for studies published between 1990 and July 2025 that enrolled patients with trauma of the pancreas and reported data on new-onset DM. Out of 906 identified records, six studies with a total of 297 patients with pancreatic trauma. The overall cumulative incidence of new-onset DM is 5.7% (95% confidence interval [CI]: 3.4%-9.0%). DM developed in 8.2% (95% CI: 4.4%-13.6%) of patients who underwent (partial) pancreatic resection and in 2.9% (95% CI: 0.8%-7.4%) of patients treated nonoperatively. For low-grade injuries, the incidence of DM was 5.5% (95% CI: 2.0%-11.5%) compared to 11.1% (95% CI: 4.9%-20.7%) for high-grade injuries. The time until new-onset diabetes mellitus was detailed in one study with 15 patients. Based on the available literature, the estimated overall incidence of DM after pancreatic trauma is 5.7%. High-grade pancreatic injury seems to increase the risk of developing new-onset DM, which is possibly influenced by their frequent surgical treatment.