Abstract
Background Identification of a specific diabetes signature associated to pancreatic ductal carcinoma (PDAC) could be a key to detect asymptomatic, early stage tumors. We aim to characterize the clinical signature and the pathogenetic factors of the different types of diabetes associated with PDAC, based on the time between diabetes and cancer diagnosis. Methods Prospective observational study on 364 PDAC patients admitted to a referral center for pancreatic disease. Hospital and/or outpatient medical records were reviewed. Blood biochemical values including fasting blood glucose, insulin and/or C-peptide, glycosylated hemoglobin and anti-islet antibodies were determined. Diabetes onset was assessed after surgery and during follow-up. Results The prevalence of diabetes in patients was 67%. Considering 174 patients (47.8%) already having diabetes when diagnosed with PDAC (long duration, short duration, concomitant), the clinical and biochemical profile was similar to that of patients with type 2 diabetes (T2D). Diabetes was associated with known risk factors (i.e., age, sex, family history for diabetes and increased BMI) and both beta-cell dysfunction and insulin resistance were present. Considering 70 patients (19.2%) with onset of diabetes after PDAC diagnosis (early and late onset), the strongest predictor was the loss of beta-cell mass following pancreatectomy in patients with risk factors for T2D. Conclusion Different types of diabetes according to the time between diabetes and PDAC diagnosis are clinical entities widely overlapping with T2D. Therefore, the success of a strategy considering diabetes onset as a marker of asymptomatic PDAC will largely depend on our ability to identify new diabetes-unrelated biomarkers of PDAC.
| Original language | English |
|---|---|
| Pages (from-to) | 844-852 |
| Number of pages | 9 |
| Journal | Pancreatology |
| Volume | 16 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Sep 1 2016 |
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Keywords
- Diabetes
- Human
- Pancreatic ductal carcinoma
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Hepatology
- Endocrinology
Cite this
Diabetes associated with pancreatic ductal adenocarcinoma is just diabetes : Results of a prospective observational study in surgical patients. / Dugnani, Erica; Gandolfi, Alessandra; Balzano, Gianpaolo; Scavini, Marina; Pasquale, Valentina; Aleotti, Francesca; Liberati, Daniela; Di Terlizzi, Gaetano; Petrella, Giovanna; Reni, Michele; Doglioni, Claudio; Bosi, Emanuele; Falconi, Massimo; Piemonti, Lorenzo.
In: Pancreatology, Vol. 16, No. 5, 01.09.2016, p. 844-852.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diabetes associated with pancreatic ductal adenocarcinoma is just diabetes
T2 - Results of a prospective observational study in surgical patients
AU - Dugnani, Erica
AU - Gandolfi, Alessandra
AU - Balzano, Gianpaolo
AU - Scavini, Marina
AU - Pasquale, Valentina
AU - Aleotti, Francesca
AU - Liberati, Daniela
AU - Di Terlizzi, Gaetano
AU - Petrella, Giovanna
AU - Reni, Michele
AU - Doglioni, Claudio
AU - Bosi, Emanuele
AU - Falconi, Massimo
AU - Piemonti, Lorenzo
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background Identification of a specific diabetes signature associated to pancreatic ductal carcinoma (PDAC) could be a key to detect asymptomatic, early stage tumors. We aim to characterize the clinical signature and the pathogenetic factors of the different types of diabetes associated with PDAC, based on the time between diabetes and cancer diagnosis. Methods Prospective observational study on 364 PDAC patients admitted to a referral center for pancreatic disease. Hospital and/or outpatient medical records were reviewed. Blood biochemical values including fasting blood glucose, insulin and/or C-peptide, glycosylated hemoglobin and anti-islet antibodies were determined. Diabetes onset was assessed after surgery and during follow-up. Results The prevalence of diabetes in patients was 67%. Considering 174 patients (47.8%) already having diabetes when diagnosed with PDAC (long duration, short duration, concomitant), the clinical and biochemical profile was similar to that of patients with type 2 diabetes (T2D). Diabetes was associated with known risk factors (i.e., age, sex, family history for diabetes and increased BMI) and both beta-cell dysfunction and insulin resistance were present. Considering 70 patients (19.2%) with onset of diabetes after PDAC diagnosis (early and late onset), the strongest predictor was the loss of beta-cell mass following pancreatectomy in patients with risk factors for T2D. Conclusion Different types of diabetes according to the time between diabetes and PDAC diagnosis are clinical entities widely overlapping with T2D. Therefore, the success of a strategy considering diabetes onset as a marker of asymptomatic PDAC will largely depend on our ability to identify new diabetes-unrelated biomarkers of PDAC.
AB - Background Identification of a specific diabetes signature associated to pancreatic ductal carcinoma (PDAC) could be a key to detect asymptomatic, early stage tumors. We aim to characterize the clinical signature and the pathogenetic factors of the different types of diabetes associated with PDAC, based on the time between diabetes and cancer diagnosis. Methods Prospective observational study on 364 PDAC patients admitted to a referral center for pancreatic disease. Hospital and/or outpatient medical records were reviewed. Blood biochemical values including fasting blood glucose, insulin and/or C-peptide, glycosylated hemoglobin and anti-islet antibodies were determined. Diabetes onset was assessed after surgery and during follow-up. Results The prevalence of diabetes in patients was 67%. Considering 174 patients (47.8%) already having diabetes when diagnosed with PDAC (long duration, short duration, concomitant), the clinical and biochemical profile was similar to that of patients with type 2 diabetes (T2D). Diabetes was associated with known risk factors (i.e., age, sex, family history for diabetes and increased BMI) and both beta-cell dysfunction and insulin resistance were present. Considering 70 patients (19.2%) with onset of diabetes after PDAC diagnosis (early and late onset), the strongest predictor was the loss of beta-cell mass following pancreatectomy in patients with risk factors for T2D. Conclusion Different types of diabetes according to the time between diabetes and PDAC diagnosis are clinical entities widely overlapping with T2D. Therefore, the success of a strategy considering diabetes onset as a marker of asymptomatic PDAC will largely depend on our ability to identify new diabetes-unrelated biomarkers of PDAC.
KW - Diabetes
KW - Human
KW - Pancreatic ductal carcinoma
UR - http://www.scopus.com/inward/record.url?scp=84991716493&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84991716493&partnerID=8YFLogxK
U2 - 10.1016/j.pan.2016.08.005
DO - 10.1016/j.pan.2016.08.005
M3 - Article
VL - 16
SP - 844
EP - 852
JO - Pancreatology
JF - Pancreatology
SN - 1424-3903
IS - 5
ER -