Pancreatic cancer link to worsening type 2 diabetes

Healthcare professionals have highlighted that the onset of type 2 diabetes, or a rapid deterioration in people that have the condition could be an early warning sign of pancreatic cancer.

Researchers found that almost half of people with type 2 diabetes that had pancreatic cancer were diagnosed within one year of being diagnosed with type 2 diabetes.

The study looked at almost 1 million people with type 2 diabetes in Lombardy (Italy) and Belgium. Findings of the study by researchers in France were presented at the European Cancer Congress 2017 (ECCO) recently.

Alice Koechlin, from the International Prevention Research Institute in Lyon, France, who carried out the study, said: “In Belgium 25% of cases were diagnosed within 90 days and in Lombardy it was 18%. After the first year, the proportion of diagnosed pancreatic cancers dropped dramatically.”

Researchers found that people with type 2 diabetes who were able to continue with oral anti-diabetic drugs, patients in Belgium and in Lombardy were more likely to be diagnosed with pancreatic cancer in the first three months after their first prescription for incretins (metabolic hormones that stimulate the pancreas to produce more insulin to lower blood glucose levels). Over time this risk fell after the first year of being diagnosed with type 2 diabetes.

Among people who already had type 2 diabetes and were managing the condition with oral anti-diabetic drugs, the switch to incretins or insulin happened faster among people with type 2 diabetes who were subsequently diagnosed with pancreatic cancer. In addition, a deterioration in their condition was linked with a higher risk of being diagnosed with pancreatic cancer.

Professor Philippe Autier, from the International Prevention Research Institute and co-author of the study, added: “Although it has been known for some time that there is an association between type 2 diabetes and pancreatic cancer, the relationship between the two conditions is complex.

“Doctors and their patients with diabetes 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.”

Ms Koechlin added: “There is currently no good, non-invasive method for detecting pancreatic cancer that is not yet showing any visible signs or symptoms. We hope that our results will encourage the search for blood markers indicating the presence of pancreatic cancer, which could guide decisions to perform a confirmation examination like endoscopy.”

Pancreatic cancer is difficult to detect at an early stage and there are few effective treatments for it. Less than 1% of people live for 10 or more years after a diagnosis. In Europe around 104,000 new cases were diagnosed in 2012 and approximately the same number of people died from it. Worldwide there were an estimated 338,000 cases of pancreatic cancer diagnosed in 2012 and 330,000 people died from it.

Professor Peter Naredi, from the Sahlgrenska Academy, University of Gothenburg, Sweden and Chair of the Congress and President of ECCO, who was not involved with the research, said: “Due to the severity of pancreatic cancer and because only a minority of cases are detected at a curable stage, we must find better ways for early detection. Some advances have been made in the search for blood biomarkers. This study opens up the possibility to combine the diagnosis of an associated disease, type 2 diabetes, with blood biomarkers. It is a step in the right direction if we can increase the proportion of early diagnosed pancreatic cancers.”

An NHS Behind the Headlines report on the study concluded: “Among people with type 2 diabetes, diagnosis of pancreatic cancer was linked with recent onset of diabetes or rapidly deteriorating diabetes. This suggests these could both be potential warning signs of hidden pancreatic cancer and indicate the need for more investigations.

“It’s not possible to say whether the findings could lead to more in-depth investigation of people with newly diagnosed or rapidly progressing diabetes, or whether this could make earlier pancreatic cancer diagnosis and improved survival rates possible.”

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