{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:40:59Z","timestamp":1790890859870,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T00:00:00Z","timestamp":1748649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015769","name":"Dexcom","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015769","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Diabetes in patients with chronic pancreatitis is a heterogeneous condition with some patients presenting with pre\u2010existing diabetes and others developing diabetes after pancreatitis onset. We aimed to characterise beta and alpha cell function in these patients and examine differences between those with and without pre\u2010existing diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 26 patients with chronic pancreatitis and insulin\u2010treated diabetes, divided into two subgroups: 13 with pre\u2010pancreatitis diabetes (having type 2 diabetes before their chronic pancreatitis diagnosis) and 13 with post\u2010pancreatitis diabetes. Patients underwent comprehensive clinical characterisation, including an arginine stimulation test to measure fasting and stimulated levels of C\u2010peptide and glucagon. Additionally, they were monitored with continuous glucose monitoring over 20\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with chronic pancreatitis and diabetes exhibited reduced fasting and stimulated C\u2010peptide and glucagon responses to arginine, though responses varied considerably among individuals. Post\u2010pancreatitis diabetes patients had lower glucagon responses than those with pre\u2010pancreatitis diabetes (mean difference \u221219.3\u2009pmol\/L, 95% confidence interval (CI) \u221235.6 to \u22123.0). However, C\u2010peptide levels were similar between the groups. Pre\u2010pancreatitis diabetes patients spent more time in level 2 hyperglycaemia compared to post\u2010pancreatitis patients (12.9% vs. 6.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). In contrast, post\u2010pancreatitis diabetes patients had more time in both level 1 and level 2 hypoglycaemia (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05, respectively). A low glucagon response was correlated with time spent in hypoglycaemia (Rho\u2009=\u2009\u22120.54,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Diabetes in chronic pancreatitis is a heterogeneous entity. The presence of type 2 diabetes prior to chronic pancreatitis is associated with a reduced risk of alpha cell dysfunction and hypoglycaemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70080","type":"journal-article","created":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T22:37:36Z","timestamp":1748731056000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Unravelling the heterogeneity of diabetes in chronic pancreatitis: Alpha and beta cell dysfunction and association with glycaemic control"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1120-8144","authenticated-orcid":false,"given":"Line","family":"Davidsen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Centre for Pancreatic Diseases &amp; Mech\u2010Sense Aalborg University Hospital  Aalborg Denmark"},{"name":"Clinical Institute Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Lebech Cichosz","sequence":"additional","affiliation":[{"name":"Department of Health Science and Technology Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie Siggaard","family":"Knoph","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Centre for Pancreatic Diseases &amp; Mech\u2010Sense Aalborg University Hospital  Aalborg Denmark"},{"name":"Clinical Institute Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle Myriam","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Centre for Pancreatic Diseases &amp; Mech\u2010Sense Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Bisgaard","family":"St\u00e6hr","sequence":"additional","affiliation":[{"name":"Department of Cardiology North Denmark Regional Hospital  Hj\u00f8rring Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Vestergaard","sequence":"additional","affiliation":[{"name":"Clinical Institute Aalborg University  Aalborg Denmark"},{"name":"Steno Diabetes Centre North Denmark Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6649-8644","authenticated-orcid":false,"given":"Morten Hasselstr\u00f8m","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Health Science and Technology Aalborg University  Aalborg Denmark"},{"name":"Data Science Novo Nordisk A\/S  S\u00f8borg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolette","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens Juul","family":"Holst","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asbj\u00f8rn Mohr","family":"Drewes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Centre for Pancreatic Diseases &amp; Mech\u2010Sense Aalborg University Hospital  Aalborg Denmark"},{"name":"Clinical Institute Aalborg University  Aalborg Denmark"},{"name":"Steno Diabetes Centre North Denmark Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Trunk\u2010Black","family":"Juel","sequence":"additional","affiliation":[{"name":"Center for Clinical Metabolic Research, Gentofte Hospital University of Copenhagen  Hellerup Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip Krag","family":"Knop","sequence":"additional","affiliation":[{"name":"Center for Clinical Metabolic Research, Gentofte Hospital University of Copenhagen  Hellerup Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren Schou","family":"Olesen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Centre for Pancreatic Diseases &amp; 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