New Onset Diabetes, Especially In Lean Patients, Can Be Marker of Pancreatic Cancer Interview with:
Dr. Pavel Škrha
Charles University, Prague
Czech Republic What is the background for this study? What are the main findings?

Response: Incidence of pancreatic cancer (PAC) is still increasing. The main problem is in the late diagnosis of the cancer. It was found, that diabetes mellitus was much more frequent in the pancreatic cancer patients than in the general population. DM can be already the first symptom of the disease (secondry T3cDM).

In our study nearly 80 % of all the pancreatic cancer patients had DM/prediabetes and it was of new-onset (less than 2 years before the cancer diagnosis) in 73 % out of them. We have measured the current marker of PAC (CA 19-9) together with serum microRNA-196 and -200 (that we have chosen in the previous pilot study). All the markers were significantly elevated in the pancreatic cancer patients, without any difference between the subgroups according to DM presence/absence. While the sensitivity of CA 19-9 alone (to detect the cancer) was 85 % (specificity 73 %), combining all the three markers improved it to 95 % (specificity 77 %). In the pancreatic cancer group, there were only six patients with T1 or T2 stage (others had an advanced stage of the disease – T3, T4). While CA 19-9 alone identified only 2 patients of them, the combined test identified all the six patients (data not shown in the poster). What should readers take away from your report?

Response: New-onset DM/prediabetes can be already the first symptom of the PAC. If the patient with the new-onset DM (not T1DM) is lean, if he recently had lost weight or the diabetic treatment needs to be escalated soon (for example with insulin), he should be screened for the  pancreatic cancer . Nowadays, imaging methods are in the first line. Maybe in the future, a simple blood test (CA 19-9 together with the miRNAs) will be the method of choice. What recommendations do you have for future research as a result of this study?

Response: The markers need to be validated in larger studies, a prospective study with new-onset DM non-obese patients should be performed. Specificity of the markers should be tested in other malignancies. Thank you for your contribution to the community.


EASD 2016

Newonset diabetes mellitus as a target for pancreatic cancer screening

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on September 19, 2016 by Marie Benz MD FAAD