title: Impact of diabetes mellitus on the outcome of pancreatic cancer.
abstract: BACKGROUND
  Diabetes mellitus (DM) has the potential to impact the pathogenesis, treatment, and outcome of pancreatic cancer. This study evaluates the impact of DM on pancreatic cancer survival.
  
  
  METHODS
  We conducted a retrospective cohort study from the Veterans Affairs (VA) Central Cancer Registry (VACCR) for pancreatic cancer cases between 1995 and 2008. DM and no-DM cases were identified from comorbidity data. Univariate and multivariable analysis was performed. Multiple imputation method was employed to account for missing variables.
  
  
  RESULTS
  Of 8,466 cases of pancreatic cancer DM status was known in 4728 cases that comprised this analysis. Males accounted for 97.7% cases, and 78% were white. Overall survival was 4.2 months in DM group and 3.6 months in the no-DM group. In multivariable analysis, DM had a HR = 0.91 (0.849-0.974). This finding persisted after accounting for missing variables using multiple imputations method with the HR in DM group of 0.93 (0.867-0.997).
  
  
  CONCLUSIONS
  Our data suggest DM is associated with a reduction in risk of death in pancreatic cancer. Future studies should be directed towards examining this association, specifically impact of DM medications on cancer outcome.
authors.affiliation: Department of Internal Medicine, Division of Hematology/Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Muhammad Shaalan
authors.initials: MS
authors.lastname: Beg
authors.affiliation: Division of Biostatistics and Epidemiology, Department of Biomedical Sciences, Texas Tech University Health Sciences Center, El Paso, Texas, United States of America.
authors.forename: Alok Kumar
authors.initials: AK
authors.lastname: Dwivedi
authors.affiliation: Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America.
authors.forename: Syed Arif
authors.initials: SA
authors.lastname: Ahmad
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Sadia
authors.initials: S
authors.lastname: Ali
authors.affiliation: Division of Hematology/Oncology, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America.
authors.forename: Olugbenga
authors.initials: O
authors.lastname: Olowokure
mesh_terms: D000368:Aged; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology; D012189:Retrospective Studies; D012306:Risk