New-onset diabetes mellitus after distal pancreatectomy research status, trends, and risk factors.

BACKGROUND

This study combines bibliometric analysis and meta-analysis to map global research trends in new-onset diabetes mellitus (NODM) after distal pancreatectomy(DP), identify emerging trends, and perform quantitative analysis of risk factors.

METHODS

We selected 57 articles (2006-2025) from the Web of Science Core Collection and analyzed them using VOSviewer, CiteSpace, and R. Following PRISMA 2020 guidelines, we meta-analyzed 27 studies (2,275 patients) to evaluate 23 risk factors across seven dimensions. Statistical synthesis involved fixed/random-effects models, subgroup analysis, and sensitivity analysis.

RESULTS

Bibliometric analysis reveals three developmental phases, with a 2020 publication peak. The US (16 articles), Japan, and Korea lead in research output, forming hubs around institutions like Seoul National University and Columbia University. Keyword clustering identifies four core research areas and frontiers. Future research will focus on in-depth risk factor analysis and building a specific NODM management system. Meta-analysis shows a pooled NODM incidence of 28% (95% CI: 25%-32%, P < .001). A variety of significant risk factors have been identified, including patient-related factors such as Age (OR 1.03, 95% CI: 1.01-1.05, P = 0.003), Gender (OR 1.23, 95% CI: 1.14-1.34, P < 0.001), BMI (OR 1.09, 95% CI: 1.03-1.15, P < 0.001), HbA1c (OR 4.02, 95% CI: 2.55-6.32, P < .001), and Chronic Pancreatitis (OR 2.27, 95% CI: 1.79-2.88, P < .001); surgery-related factors such as Splenectomy (OR 1.87, 95% CI: 1.44-2.43, P < .001) and Resected Pancreatic Volume (OR 2.97, 95% CI: 1.18-3.07, P = .009); and lifestyle and genetic factors such as Smoking (OR 1.30, 95% CI: 1.15-1.47, P < .001) and family history of diabetes (OR 1.73, 95% CI: 1.42-2.11, P < .001). Heterogeneity was mainly influenced by regional differences, follow-up duration, and study design.

CONCLUSION

NODM is a common post-distal pancreatectomy complication, with a 28% incidence influenced by multiple factors. Key modifiable and non-modifiable risk factors provide evidence for risk stratification. Future research should focus on validating prediction models, constructing a diagnosis and treatment system, and developing pancreatic-sparing techniques.