​Type 2 diabetes, chronic pancreatitis, and pancreatic cancer are common and interrelated diseases that require better approaches to diagnosis and treatment. NIDDK and NCI together formed a consortium of many centers called CPDPC (chronic pancreatitis, diabetes, and pancreatic cancer). Under the leadership of Santhi Swaroop's Vege as the PI, the consortium is in its tenth year and now applying for the new 5-year cycle NIDDK Grant, CPCRC (chronic pancreatitis clinical research consortium). During these 9 years, for the 3 main studies PROCEED, DETECT, and NOD, Mayo Clinic was at the top for recruitment of patients as well as for the ancillary studies like MINIMAP, PAIR, and IMPACT.

 

 

We could also plan and complete ancillary studies, which included a salivary biomarker study, PAIR, and IMPACT. We are now applying for the third 5-year cycle, which will involve acute recurrent pancreatitis and chronic pancreatitis in adults at our center. We will try to full fill the goals and strategies of the CPCRC with regards to ongoing recruitment of participants, follow-up of the large number of participants already in the study during the first 2 cycles, continuing the collection of various bio specimens successfully as has been done for 9 years, and new ancillary studies understanding the pathogenesis of the disease as well as clinical trials (2 planned 1 in diabetes and 1 in smoking and chronic pancreatitis).

 

 

In addition to the experienced PI and the co-investigators who have all been involved in this consortium so far, the two experienced study coordinators who have done exemplary work towards the goals of the second cycle of the consortium will form the team and work with the PI and co-investigators. We have a well-standardized mechanism to identify new patients with acute recurrent pancreatitis and chronic pancreatitis, request them for bio specimens, collection, storage, and shipment of those bio specimens to the central bio repository, frequent discussions with the monitoring team and other coordinating centers, and participation in face-to-face meetings by all the consortium centers when required.

 

 

A detailed proposal for all three 3-aims of recruitment, collection of bio specimens, and planning new studies to understand the pathogenesis, including interventional trials, is being submitted to NIDDK.

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Public Health Relevance Statement

The main aims are:

1. Identification and recruitment of adult patients with acute recurrent pancreatitis and chronic pancreatitis.

2. Collection of bio specimens from the participants including blood, saliva, urine, stool and when possible pancreatic juice.

3. A. Studying the differences between chronic pancreatitis with prior acute pancreatitis and the group without prior acute pancreatitis with regards to genetic, metabolic, immunologic markers, and quality of life. B. Conduct a Phase 2 randomized controlled trial of multiple daily insulin injections with continuous glucose monitoring versus automated insulin delivery for therapy of advanced diabetes (requiring complex insulin therapy in addition to other non-insulin antihyperglycemic medications) in CP. C. Pilot trial of smoking cessation in chronic pancreatitis.