Abstract
Introduction. Pancreatic cancer (PC) is characterized by asymptomatic, aggressive course, high mortality and low patients survival. Patients with diabetes mellitus (DM) have an increased risk of PC, but there are two views of diabetes: as a risk factor or as a PC marker. The aim of the study was to investigate the role of pathogenetic factors of type 2 diabetes in the development of PC. Materials and methods. The study included 42 participants that were divided into groups: I — healthy (control group) (n = 10), II — patients with type 2 diabetes mellitus (n = 13), III — non-diabetic patients with PC (n = 11), IV — patients with a combination of PC and type 2 diabetes (n = 8). DM compensation was determined by the level of glycosylated haemoglobin (HbA1c) and ion-exchange chromatography. The levels of insulin and insulin-like growth factor-1 (IGF-1) were determined by immune-enzymatic methods. Results and discussion. Significant hyperinsulinemia was revealed only in patients of group II with type 2 diabetes compared with the control group (P = 0.0001), group III (P = 0.0002) and group IV (P = 0.04). Increased level of IGF-1 compared to the control group was detected in patients of group II with type 2 DM (P = 0.04) and in patients of group III with PC (P = 0.004). PC was diagnosed in non-obese patients of group IV with an average duration of diabetes up to 3 years. In patients of groups II and IV, the level of HbA1c was determined 7.68 % and 8.20 %, respectively and did not differ significantly between the groups (P > 0.05). Conclusions. In the examined patients with pancreatic cancer that occurred on the background of type 2 diabetes mellitus, obesity, hyperinsulinemia and elevated IGF-1 levels were not revealed, which leads us to suggestion that they have secondary diabetes (T3cDM). Type 2 diabetes, first detected in patients without obesity and without hyperinsulinemia, should be differentiated from T3cDM. Patients with newly diagnosed type 2 diabetes are advised to screen for pancreatic cancer, since diabetes can be both a marker and a risk factor of cancer of this localization.
Highlights
Pancreatic cancer (PC) takes a special place in the structure of oncological diseases as it has an asymptomatic aggressive course and is characterized by high mortality and low patients survival [1].The prevalence of PC varies across regions and populations
The duration of diabetes mellitus (DM) in patients with cancer-free group II was significantly higher than in patients with PC diagnosed in the background of DM (P = 0.02)
The obtained results coincide with the findings of other studies, which confirm the diagnosis of PC with a short history of type 2 DM [14, 15]
Summary
Pancreatic cancer (PC) takes a special place in the structure of oncological diseases as it has an asymptomatic aggressive course and is characterized by high mortality and low patients survival [1].The prevalence of PC varies across regions and populations. Pancreatic cancer (PC) takes a special place in the structure of oncological diseases as it has an asymptomatic aggressive course and is characterized by high mortality and low patients survival [1]. The highest incidence is in Europe (7.7 per 100 000 people), North America (7.6 per 100 000 people), and the lowest is in Africa (2.2 per 100 000 people) Men suffer from this disease more often but the indicators differ in different regions [2]. About 73% of patients die within 1 year of diagnosis This type of cancer ranks ninth in prevalence and sixth among the causes of death from malignant diseases [3]. Pancreatic cancer (PC) is characterized by asymptomatic, aggressive course, high mortality and low patients survival. Patients with diabetes mellitus (DM) have an increased risk of PC, but there are two views of diabetes: as a risk factor or as a PC marker.
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