Diabetes and Its Relationship to Pancreatic Carcinoma

The link between pancreatic cancer (PC) and diabetes mellitus is recognized, however
controversy still exists because no criteria have been established for the efficient
selection of a high-risk group among patients with diabetes mellitus. Regulation of
endocrine cell mass is thought to have a central role in the pathogenesis of both diseases.
The processes that operate during pancreatic adaptation to a changing hormonal
milieu are important in pancreatic carcinogenesis. There is evidence that
somatostatin and its receptors are fundamental regulators of endocrine cell mass and
are involved in islet tumorigenesis [57].
A hospital-based case-control study revealed that cigarette smoking, family history
of PC, heavy alcohol consumption (60 ml ethanol/day) and diabetes mellitus
are significant risk factors for PC. The significant synergy between these risk factors
suggests a common pathway for carcinogenesis of the pancreas [58].
Because of the poorly understood temporal association between diabetes mellitus
and PC, a research group at the Mayo Clinic College of Medicine, Rochester,
Minn., USA [59] compared temporal patterns in diabetes prevalence in PC and
controls. Diabetes has a high prevalence in PC and frequently is now onset.
Longstanding type 2 diabetes increases the risk of PC by approximately 50%.
Furthermore, there seems to be a positive association between obesity and PC [60].
However, as the mechanisms for these associations remain speculative, further
studies are deserved. Above all, there is an urgent need for the identification of
specific biomarkers for PC-induced diabetes, which may allow screening for PC in
new-onset diabetes.