Original articleNew-onset diabetes in pancreatic cancer: A study in the primary care setting
Section snippets
Background
The association between diabetes mellitus (DM) and pancreatic cancer (PaC) has been known for over a century. It is now well understood that while long-standing diabetes is an etiologic factor for pancreatic cancer, new-onset diabetes can be a manifestation of the cancer [1]. A recent meta-analysis of 17 case–control and 19 cohort (or nested case–control) studies published between 1966 and 2005 reported that the combined age- and sex-adjusted odds ratio (OR) for PaC associated with DM was 1.82
Methods
This study was approved by the Mayo Foundation Institutional Review Board.
Patient demographics (Table 1)
The cohort of 111 PaC patients (59 males, 52 females) had a median age of 74 years (range 38–100 years). A prior or current history of smoking was noted in 61% of patients. Having at least one family member with DM was noted for 42% of patients. The sub-group of patients with DM (n = 52) comprised 23 females and 29 males with a median age of 74.5 years (range 39–90 years); in addition, there was a history of smoking in 64% and a positive family history of DM in 46%.
Cancer-specific symptoms (Table 2)
Cancer-specific symptoms were
Discussion
In this retrospective study of 111 consecutive PaC patients followed in the Mayo Clinic primary care clinics, we show that the prevalence of DM is high (47%). The majority (58%) of DM in PaC is new-onset (<36 months in duration). Among 30 PaC subjects with new-onset DM, 24 (80%) had no symptoms of PaC when they first met criteria for DM. The diagnosis of DM was made at its onset in only 5/24 (21%) patients with DM and asymptomatic PaC. In fact, in nearly one-fourth (6/24) of patients, the
Conflict of interest/disclosure
None declared.
Grant support
Dr. Chari’s research was funded by grants from NIH (R01 CA 100685) and the Mayo Clinic SPORE in Pancreatic Cancer (P50 CA 102701).
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