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Review
. 2023 Jul 19;15(14):3669.
doi: 10.3390/cancers15143669.

Diabetes Mellitus in Pancreatic Cancer: A Distinct Approach to Older Subjects with New-Onset Diabetes Mellitus

Jan Bures  1   2   3 , Darina Kohoutova  3   4 , Jan Skrha  5 , Bohus Bunganic  2 , Ondrej Ngo  6   7 , Stepan Suchanek  1   2 , Pavel Skrha  8 , Miroslav Zavoral  1   2
Affiliations
Review

Diabetes Mellitus in Pancreatic Cancer: A Distinct Approach to Older Subjects with New-Onset Diabetes Mellitus

Jan Bures et al. Cancers (Basel). .

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) is associated with a very poor prognosis, with near-identical incidence and mortality. According to the World Health Organization Globocan Database, the estimated number of new cases worldwide will rise by 70% between 2020 and 2040. There are no effective screening methods available so far, even for high-risk individuals. The prognosis of PDAC, even at its early stages, is still mostly unsatisfactory. Impaired glucose metabolism is present in about 3/4 of PDAC cases.

Methods: Available literature on pancreatic cancer and diabetes mellitus was reviewed using a PubMed database. Data from a national oncology registry (on PDAC) and information from a registry of healthcare providers (on diabetes mellitus and a number of abdominal ultrasound investigations) were obtained.

Results: New-onset diabetes mellitus in subjects older than 60 years should be an incentive for a prompt and detailed investigation to exclude PDAC. Type 2 diabetes mellitus, diabetes mellitus associated with chronic non-malignant diseases of the exocrine pancreas, and PDAC-associated type 3c diabetes mellitus are the most frequent types. Proper differentiation of particular types of new-onset diabetes mellitus is a starting point for a population-based program. An algorithm for subsequent steps of the workup was proposed.

Conclusions: The structured, well-differentiated, and elaborately designed approach to the elderly with a new onset of diabetes mellitus could improve the current situation in diagnostics and subsequent poor outcomes of therapy of PDAC.

Keywords: age over 60 years; diagnostic algorithm; new-onset diabetes mellitus; pancreatic ductal adenocarcinoma.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the manuscript; in the collection and interpretation of own and literature data; in the concept of a distinct approach to older subjects with new-onset diabetes mellitus; in the writing of the manuscript, or in the decision to publish it.

Figures

Figure 1
Figure 1
Algorithm for the management of subjects over 60 with new-onset diabetes mellitus of any type. Drawing by Hana Kotlandova. Note: Diabetes mellitus “DIS-IR” in this context means diabetes mellitus characterized by decreased insulin secretion and increased insulin resistance. Diabetes mellitus “DIS-NSI” in this context means diabetes mellitus characterized by decreased insulin secretion and normal sensitivity to insulin.
See this image and copyright information in PMC

References

    1. Pereira S.P., Oldfield L., Ney A., Hart P.A., Keane M.G., Pandol S.J., Li D., Greenhalf W., Jeon C.Y., Koay E.J., et al. Early detection of pancreatic cancer. Lancet Gastroenterol. Hepatol. 2020;5:698–710. doi: 10.1016/S2468-1253(19)30416-9. - DOI - PMC - PubMed
    1. Siegel R.L., Miller K.D., Fuchs H.E., Jemal A. Cancer Statistics, 2021. CA Cancer J. Clin. 2021;71:7–33. doi: 10.3322/caac.21654. - DOI - PubMed
    1. Huang J., Lok V., Ngai C.H., Zhang L., Yuan J., Lao X.Q., Ng K., Chong C., Zheng Z.J., Wong M.C.S. Worldwide Burden of, Risk Factors for, and Trends in Pancreatic Cancer. Gastroenterology. 2021;160:744–754. doi: 10.1053/j.gastro.2020.10.007. - DOI - PubMed
    1. International Agency for Research on Cancer, World Health Organization. 2023. [(accessed on 9 April 2023)]. Available online: https://gco.iarc.fr.
    1. George S., Jean-Baptiste W., Yusuf Ali A., Inyang B., Koshy F.S., George K., Poudel P., Chalasani R., Goonathilake M.R., Waqar S., et al. The Role of Type 2 Diabetes in Pancreatic Cancer. Cureus. 2022;14:26288. doi: 10.7759/cureus.26288. - DOI - PMC - PubMed

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