A University of Auckland-led study has shown for the first time that a diabetes drug halves the risk of death in people with the second most common form of adult-onset diabetes, which affects at least 10,000 people in New Zealand.
Lesser known than its cousins, types 1 and 2 diabetes, diabetes of the exocrine pancreas is a form of diabetes caused by the part of the pancreas that produces digestive enzymes.
Common contributing causes are pancreatic cancer and pancreatitis, an excruciating inflammation of the pancreas.
People with this form of diabetes are known to die earlier than those with type 2 diabetes, yet there are no established treatment guidelines and researchers say the condition is under-recognised by doctors.
In the first study of its kind, a University of Auckland gathered New Zealand-wide pharmaceutical dispensing data from 2006-2015 and linked it anonymously to the hospital records of 1,862 people with diabetes of the exocrine pancreas.
They found that, in patients with diabetes after pancreatitis, the use of the diabetes drug metformin reduced the risk of death by 49 per cent compared with patients who had never taken any diabetes drugs.
The survival benefit of metformin was even more pronounced than in patients with type 2 diabetes, whose risk of death was reduced by 25 per cent.
However, in patients with diabetes related to pancreatic cancer, metformin did not boost survival odds.
“Strikingly, almost a third - 31 per cent - of the people whose records we looked at did not receive any diabetes drug,” said lead author Dr Jaelim Cho, a PhD student at the university’s Faculty of Medical and Health Sciences.
“It is expected that this population will benefit from metformin use.”
Senior author and principal investigator of the group that carried out the study, Associate Professor Max Petrov, said: "Metformin, which is a long-used type 2 diabetes medication that is not expensive and easily available, should now be recommended as the front-line treatment in patients with post-pancreatitis diabetes."
He said more investigations are needed on how to best treat pancreatic cancer-related diabetes.
The study results are published in Diabetes Care, the world’s top clinical diabetes journal and the official journal of the American Diabetes Association.
Previous research from the Auckland University group showed that Māori and Pacific adults are at more than double the risk of developing post-pancreatitis diabetes than New Zealand Europeans.