Association between time in range 70-180mg/dl in early stage and severity in patients with acute pancreatitis

Abstract

Abstract Background: It is not well understood whether glucose control in the early stage of acute pancreatitis(AP) is related to the outcome. This study aimed to investigate the association between blood glucose time in range (TIR) 70–180 mg/dL in the first 72 hours(h) on admission and the progression of AP. Methods: Patients admitted with AP to the gastroenterology department of Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University between Jan 2017 and Dec 2021 were included and retrospectively evaluated. The percentage of TIR between 70 and 180 mg/dL in the first 72 h was calculated. According to the progress of AP at discharge, the patients were divided into mild pancreatitis(MAP) and moderately severe acute pancreatitis (MSAP) or severe acute pancreatitis (SAP) group.We examined the association between TIR or TIR ≥70% and the severity of AP using logistic regression models with stratification by glycosylated hemoglobin (HbA1c) level of 6.5%. Receiver operating characteristic (ROC) curves were generated to assess the ability of TIR to predict MSAP or SAP. Results: A total of 298 patients were included and 35 of them developed into MSAP or SAP. Logistic regression analyses indicated that TIR was independently associated with the incidence of more serious AP(OR=0.962 95% CI=0.941-0.983, P=0.001). This association remained significant in patients with HbA1c ≤6.5% (OR=0.928 95%CI=0.888-0.969, P=0.001).TIR≥70% was independently associated with reduced severity only in patients with well-antecedent control (OR=0.238; 95% CI= 0.071-0.802; P =0.020). TIR was not powerful enough to predict the severity of AP in both patients with poor antecedent glucose control (AUC=0.641) or with HbA1c＜6.5% (AUC=0.668). Conclusions ：TIR was independently associated with severity in AP patients, particularly those with good antecedent glucose control.