Diabetes and pancreatic cancer: Chicken or egg?

J. Trent Magruder, Dariush Elahi, Dana K. Andersen

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Although half of all patients with pancreatic cancer are diabetic at the time of diagnosis, it remains unclear whether the diabetes associated with pancreatic cancer is a cause or an effect of the malignancy. METHODS: Epidemiologic studies were reviewed, the geographic prevalence of diabetes and the incidence of pancreatic cancer were examined, and clinical and laboratory studies were reviewed. RESULTS: Long-standing diabetes increases the risk of pancreatic cancer by 40% to 100%, and recent-onset diabetes is associated with a 4- to 7-fold increase in risk, such that 1% to 2% of patients with recent-onset diabetes will develop pancreatic cancer within 3 years. Treatment of diabetes or morbid obesity decreases the risk of pancreatic cancer, and metformin therapy decreases the risk due to both its antidiabetic and antineoplastic effects. Recent-onset diabetes associated with pancreatic cancer likely represents secondary or type 3 diabetes. The discrimination of type 3 diabetes from the more prevalent type 2 diabetes may identify the high-risk subgroup of diabetic patients in whom potentially curable pancreatic cancer may be found. CONCLUSIONS: Type 2 and type 1 diabetes mellitus increase the risk of pancreatic cancer with a latency period of more than 5 years. Type 3 diabetes mellitus is an effect, and therefore a harbinger, of pancreatic cancer in at least 30% of patients.

Original languageEnglish (US)
Pages (from-to)339-351
Number of pages13
JournalPancreas
Volume40
Issue number3
DOIs
StatePublished - Apr 2011

Fingerprint

Pancreatic Neoplasms
Type 2 Diabetes Mellitus
Morbid Obesity
Metformin
Type 1 Diabetes Mellitus
Hypoglycemic Agents
Antineoplastic Agents
Epidemiologic Studies
Diabetes Mellitus
Incidence
Therapeutics

Keywords

  • diabetes
  • hyperinsulinemia
  • metformin
  • pancreatic cancer
  • pancreatic polypeptide (PP)
  • type 3 diabetes mellitus (T3DM)

ASJC Scopus subject areas

  • Hepatology
  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Magruder, J. T., Elahi, D., & Andersen, D. K. (2011). Diabetes and pancreatic cancer: Chicken or egg? Pancreas, 40(3), 339-351. https://doi.org/10.1097/MPA.0b013e318209e05d

Diabetes and pancreatic cancer : Chicken or egg? / Magruder, J. Trent; Elahi, Dariush; Andersen, Dana K.

In: Pancreas, Vol. 40, No. 3, 04.2011, p. 339-351.

Research output: Contribution to journalArticle

Magruder, JT, Elahi, D & Andersen, DK 2011, 'Diabetes and pancreatic cancer: Chicken or egg?', Pancreas, vol. 40, no. 3, pp. 339-351. https://doi.org/10.1097/MPA.0b013e318209e05d
Magruder, J. Trent ; Elahi, Dariush ; Andersen, Dana K. / Diabetes and pancreatic cancer : Chicken or egg?. In: Pancreas. 2011 ; Vol. 40, No. 3. pp. 339-351.
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