OBJECTIVES: This study aimed to identify the risk profile for postpancreatitis diabetes mellitus (PPDM) in children after a single acute pancreatitis (AP) episode and to investigate the association between episode severity and complications, length of stay (LOS), and intensive care unit (ICU) needs. METHODS: This cross-sectional study used the Pediatric Health Information System database for patients ≤19 years old with index AP admissions (2011-2020). A query (2012-2021) was performed for diabetes mellitus (DM). Patients with prior DM or pancreatic surgery before AP or DM diagnoses were excluded. RESULTS: Out of 12,822 patients with index AP admissions (median age, 13.4 years
54% female), 686 (5.4%) developed PPDM, with 320 (2.5%) during and 366 (2.9%) at a later admission. The median time to PPDM was 1.9 months (interquartile range: 0-20.8 months). Patients with PPDM experienced extended LOS, heightened ICU needs, and increased complications such as sepsis, pancreatic necrosis, and cyst formation, along with higher rates of organ dysfunction and comorbidities. CONCLUSIONS: Children face DM risks during or after AP episodes. Enhanced DM screening and close outpatient follow-up within 3 to 6 months post-discharge are recommended.