Diabetes Could Be A Warning Sign Of Pancreatic Cancer

Diabetes Could Be A Warning Sign Of Pancreatic Cancer

"Experts have revealed the onset of diabetes, or existing diabetes getting much worse could be a sign of hidden pancreatic cancer," reports The Daily Express.
The media reports follow a press release of a study presented at the European Cancer Congress (ECCO) yesterday. The research analysed nearly a million people with type 2 diabetes in Belgium and Italy, some of whom went on to be diagnosed with pancreatic cancer.

The recent onset of diabetes appeared to be a possible warning sign of pancreatic cancer, with 25% of cases in Belgium and 18% in Italy being diagnosed within three months of a diabetes diagnosis. Faster progression of diabetes (where patients needed insulin or other more intensive treatments sooner) was also associated with a greater chance of being diagnosed with pancreatic cancer.
Pancreatic cancer is rare and often has a poor outcome, partly because it is difficult to detect at an early stage. However, it's important to put these findings in context. Diabetes has previously been linked with pancreatic cancer, though it is unclear why. It could be that diabetes increases the risk of pancreatic cancer. What is probably more likely is that rapid onset or progression of diabetes could be a symptom of the cancer itself.

Diabetes is fairly common in the UK, with around 4 million cases, while pancreatic cancer remains very rare. Just because you have diabetes does not mean you will go on to get pancreatic cancer. However, if you are concerned that you may have diabetes or that your diabetes is poorly controlled, you should talk to your GP. There are also steps you can take to reduce your risk of developing diabetes.
The study was carried out by researchers from the International Prevention Research Institute in Lyon, France. The study has not yet been published in a journal but was presented at the European Cancer Congress held in Amsterdam. The findings come from the press release.

The researchers used a prescription database (the Inter Mutualist Agency AIM-IMA) to identify 368,377 people receiving treatment for type 2 diabetes patients in Belgium between 2008 and 2013. They also identified 456,311 being treated in Lombardy, Italy, between 2008 and 2012.
These data were linked to pancreatic cancer data from the Belgium Cancer Registry and hospital discharge databases in Lombardy.
The rates of pancreatic cancer were analysed in association with time of first prescription of diabetes drugs, and use of different diabetes treatments.

What were the basic results?
In Belgium, 885 of 368,377 people with diabetes had pancreatic cancer. In Lombardy, 1,872 of 456,311 people with diabetes had pancreatic cancer.
Among all those with pancreatic cancer in the two regions, 50% had been diagnosed within one year of being diagnosed with type 2 diabetes.
In Belgium, 25% of pancreatic cancer cases were diagnosed within 90 days and in Lombardy 18% were diagnosed within 90 days.
When considering treatment, the researchers generally found that switching to more intensive diabetes treatments was also linked with a greater risk of pancreatic cancer diagnosis:

  • People who switched from oral diabetes drugs to more intensive treatment of incretin-based therapy (injected drugs that help the body produce more insulin) had 3.3 times the risk (95% confidence interval [CI] 2.0 to 5.5) of cancer diagnosis in the following three months.
  • This decreased to around a two-fold risk for 3 to 6 months after the first prescription of incretin drugs (hazard ratio [HR] 2.3, 95% CI 1.2 to 4.7) and again for 6 to 12 months after the first prescription (HR 2.1, 95% CI 1.2 to 3.9).
  • Switch from oral diabetes drugs or incretin to insulin injections was also linked with increased risk of pancreatic cancer (HR 11.9, 95% CI 10.4 to 13.6).
  • When comparing those who developed pancreatic cancer with those who remained cancer-free, switching from oral diabetes drugs to incretin or insulin injections happened sooner after diabetes diagnosis in those who developed cancer: median 372 days to switch to incretins and 315 days to switch to insulin in those who developed cancer versus median 594 days to switch to incretins and 437 days to switch to insulin.

The lead researcher commented:

"There is currently no good, non-invasive method for detecting pancreatic cancer that is not yet showing any visible signs or symptoms. We hope that our results will encourage the search for blood markers indicating the presence of pancreatic cancer, which could guide decisions to perform a confirmation examination like endoscopy."

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