INS and alkaline phosphatase measurement: Specifically, when compared with individuals with PPDM who had never used insulin, the long-term use of insulin was associated with an increased risk of progression from the first episode of AP to recurrent AP or CP among individuals with PPDM who were insulin-naïve (adjusted HR: 1.56; 95% CI: 1.15 to 2.11), after adjustment for pancreatic-related factors (i.e., aetiology, severity, and time since last AP attack) [131].