Issue: June 25, 2013
March 13, 2013
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New-onset diabetes highly prevalent among patients with pancreatic cancer

Issue: June 25, 2013
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Patients with pancreatic cancer had diabetes, particularly new-onset diabetes, significantly more frequently than those with other cancers and cancer-free participants in a recent study.

Researchers evaluated data from 500 patients with cancer, including 100 each with pancreatic, colorectal, prostate, breast and lung cancers, along with 100 matched cancer-free controls. Incidence of diabetes mellitus (DM) was observed and compared across groups. Demographic and clinical information, including family history for DM, blood glucose levels, duration of DM, and the onset and date of cancer diagnosis, also were collected.

One hundred fifty-eight patients had DM: 66 with pancreatic cancer (PaC), 18 with lung, 19 with breast, 13 with prostate and 19 with colorectal cancer, along with 23 controls. Family history for DM was similar across groups (P=.84).DM prevalence was highest in the PaC group: 68% of cases vs. 23.5% of controls, 20.7% with colorectal cancer, 19.6% with lung cancer, 19.4% with breast cancer and 14.8% with prostate cancer; P<.0001 for difference). No difference was observed in DM incidence between controls and patients with other evaluated cancers (P=.49).

Among 136 cases with data on DM duration, PaC patients had a median duration of 6 months compared with between 26 and 120 months across the other groups. Patients with PaC had early-onset DM (diagnosed within 36 months of cancer diagnosis or index date) in 40.2% of cases, compared with between 3.3% and 5.7% in the other groups (P<.0001 for difference).

“Our results lend further credence to the hypothesis that new-onset DM is indeed unique to PaC and is relatively uncommon in other patients with cancers and those without cancer, suggesting that it is not merely a reflection of an increased risk of PaC in patients with DM, but rather an early manifestation of the cancer,” the researchers concluded. “Because DM has a high prevalence in patients with PaC and develops at a time when the cancer may not even be visualized on imaging, patients with new-onset DM offer a group of high-risk patients who could be screened for sporadic pancreatic cancer.”