Our experience with pancreatic cancer and its relation to diabetes mellitus

• Published in: Časopis lékařů českých Vol. 149; no. 6; p. 291
• Main Authors: Krechler, Tomás, Zeman, Miroslav, Vecka, Marek, Jáchymová, Marie, Horejs, Josef, Krska, Zdenek, Ulrych, Jan, Dusková, Jana, Zák, Ales
• Format: Journal Article
• Language: Czech
• Published: Czech Republic 2010
• Subjects: Aged; Diabetes Mellitus, Type 2 - complications; Female; Humans; Male; Middle Aged; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - diagnosis; Prognosis; Risk Factors
• ISSN: 0008-7335

Despite the introduction of new imaging methods, the prognosis of pancreatic carcinoma (PC) remains hopeless. Therefore, there has been exerted much effort to elucidate the risk factor enabling the diagnosis of PC in the "preclinical state". At the time of PC diagnosis, more than 30% of patients suffer from diabetes mellitus, much more often than in the rest of the population. It is not clear whether DM is a risk factor for PC onset or DM appears secondary to the destruction of the gland by the tumor progression or by the effect of unknown factors produced by the cancer cells.
We enrolled 204 individuals into the study, 69 of them were controls, 70 patients had type 2 diabetes mellitus and 65 cases had newly diagnosed PC. The patients with PC had in 68% of cases disturbed glucose homeostasis and significantly higher values of insulin resistance index (HOMA-IR) in comparison with the control group. The presence of glucose homeostasis disturbances does not influence tumor staging and localization.
Results of our pilot study confirmed the so far unsatisfactory state of PC diagnostics (majority of cases fall to stages III and IV) and corroborated the close relation to DM. The early markers for the risk of pancreatic carcinoma development should be searched among the factors participating in the regulation of the glucose homeostasis and insulin sensitivity.