Surgeons can leverage a simple scoring system to predict new-onset diabetes after distal pancreatectomy, enhancing patient management.

• 26.9% of non-diabetic patients developed diabetes within 10 months post-surgery.
• Five key predictors include prediabetes, age ≥65, BMI ≥25, neck/proximal tumor, and concomitant splenectomy.
• The scoring system stratifies patients into risk categories with 5-year cumulative incidences of 4.4% (low-risk), 27.9% (intermediate), and 87.5% (high-risk).

Use this model for tailored patient counseling and targeted follow-up.