Abnormal glucose metabolism is present in almost 40% of patients after acute pancreatitis but its pathophysiology has been poorly investigated. Pancreatic hormone derangements have been sparingly studied to date and their relationship with abnormal glucose metabolism is largely unknown. The aim was to investigate the associations between pancreatic hormones and glucose metabolism after acute pancreatitis, including the effect of potential confounders. This was a cross-sectional study of 83 adult acute pancreatitis patients. Fasting venous blood was collected from all patients and used for analysis of insulin, glucagon, pancreatic polypeptide, amylin, somatostatin, C-peptide, glucose and haemoglobin A1c. Statistical analyses were conducted using the modified Poisson regression, multivariable linear regression, and Spearman's correlation. Age, sex, BMI, recurrence of acute pancreatitis, duration from first attack, severity, aetiology, etc. were adjusted for. Increased insulin was significantly associated with abnormal glucose metabolism after acute pancreatitis, in both unadjusted (p = 0.038) and adjusted (p = 0.001) analyses. Patients with abnormal glucose metabolism also had significantly decreased pancreatic polypeptide (p = 0.001), and increased amylin (p = 0.047), in adjusted analyses. Somatostatin, C-peptide, and glucagon were not changed significantly in both unadjusted and adjusted analyses. Increased insulin resistance and reduced insulin clearance may be important components of hyperinsulinaemic compensation in acute pancreatitis patients, and increased amylin and reduced pancreatic polypeptide fasting levels characterize impaired glucose homeostasis. Clinical studies investigating islet-cell hormonal responses to mixed-nutrient meal testing, euglycaemic-hyperinsulinaemic clamps are warranted for further insights into role of pancreatic hormones in glucose metabolism derangements secondary to pancreatic diseases.