Research on the relationships between pancreatic cancer and hyperglycemia in Chinese populations

Pancreatic cancer (PC) is related to diabetes. Long-standing diabetes should be a prerequisite, whereas new-onset hyperglycemia might be a result of PC. However, the association between diabetes and PC is still in dispute.

We investigated the relationship between glucose metabolism and other factors by retrospectively analyzing the clinical data of 331 PC patients. Any histopathological type was eligible. The patients were divided into three groups: group A, normal glucose metabolism; group B, hyperglycemia duration≤6 months; and group C, diabetes duration >24 months.

The prevalence of hyperglycemia was 59.5%. Most patients were diagnosed with diabetes mellitus either concomitantly with cancer (39.0%) or within 6 months before cancer diagnosis (6.9%). There were more females in group C than group A (P = 0.005) and B (P = 0.018). Patients in group A were younger (A vs B, P < 0.001; A vs C, P = 0.032) and thinner (A vs B, P = 0.013; A vs C, P = 0.027). In group C, more individuals shared a family history of diabetes (A vs C, P = 0.004; B vs C, P = 0.023), but fewer smoked (A vs C, P = 0.027; B vs C, P = 0.020). Patients in group C had a larger proportion of poorly differentiated cancer (A vs C, P = 0.002; B vs C, P = 0.012). No differences in glucose metabolism were found among the different histological types.

We further support the notion that diabetes duration >24 months might not be cancer related. Older and fatter PC patients were more likely to develop hyperglycemia. More patients with long-standing diabetes had poor tumor differentiation. We speculate that smoking and alcohol intake might advance PC onset.