Diabetes Onset Could Mean Pancreatic Cancer

Diabetes may be a sign of early undiagnosed pancreatic cancer.

Diabetes onset — or the rapid deterioration of an existing case of diabetes – may be a warning sign of early pancreatic cancer, according to the findings of a new study.

Researchers from the International Prevention Research in Lyon, France reviewed prescription data for diabetes patients in order to examine the theorized relationship between diabetes and pancreatic cancer. The researchers hypothesized that initiating or changing a pharmacological treatment for diabetes could be a warning sign for pancreatic cancer.

The researchers collected two data from two cohorts: 368,377 patients in Belgium between 2008 and 2013, and 456,311 patients from the Lombardy region of Italy from 2008 to 2012. The investigators examined the patients’ medical history, including the time of their pancreatic cancer diagnosis, first prescription of an anti diabetic drug, and any other additional prescription data.

The study authors added in a press release that pancreatic cancer is one of the deadliest because early detection is difficult and few treatments are effective. Across Europe in 2012, 104,000 new cases were diagnosed while about the same number of people died from it. And, the researchers added, less than one percent of people diagnosed with pancreatic cancer live for ten or more years after their diagnosis.

A total of 885 pancreatic cancer diagnoses were made in the Belgian cohort, while 1,872 diagnoses were made in the Italian group, the researchers determined. They found that half of all pancreatic cancer cases were diagnosed within 12 months of the patients being diagnosed with diabetes and being given their first pharmacological aid to control it. But after the first year, the proportion of diagnosed pancreatic cancers dropped significantly.

Compared to patients who were able to continue their anti diabetic drugs, the patients from the Belgian and Italian cohorts had a three and a half times greater risk for being diagnosed with pancreatic cancer in the first three months after their first prescription for incretins. Between three and six months, this risk dropped to 2.3-fold, followed by a two-fold risk between six and 12 months. After one year, the risk was 1.7-fold for those patients.

For patients who already had diabetes and used anti diabetic drugs, switching to incretins or insulin occurred faster in the patients who were later diagnosed with pancreatic cancer. When their conditions deteriorated and the patients moved to more aggressive anti diabetic therapies, the researchers learned, they were up against a sevenfold increased risk of a pancreatic cancer diagnosis.

“Our study shows that incretin therapies are often prescribed to patients whose diabetes is caused by a still undiagnosed pancreatic cancer,” explained study author Alice Koechlin in a press release. “Because the pancreatic cancer finally becomes symptomatic and is thus diagnosed, it looks like it is the intake of incretin drugs that could be the trigger of the pancreatic cancer, while in reality, it is the pancreatic cancer that causes a deterioration of diabetes, which is followed by the prescription of incretins.”

Koechlin hoped that the team’s research could be used to develop a better, non invasive system to detect pancreatic cancer.

“Doctors and their diabetic patients should be aware that the onset of diabetes or rapidly deteriorating diabetes could be the first sign of hidden pancreatic cancer, and steps should be taken to investigate it,” she concluded.

The abstract, titled “Early Detection of Pancreatic Cancer among Diabetic Patients: Results from Prescription Database Analyses,” was presented at the European Cancer Congress 2017 (ECCO2017) on January 30.

The study authors spoke in a press release titled “Diabetes or its rapid deterioration can be an early warning sign for pancreatic cancer.”

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