title: Pancreatic cancer and diabetes: A two-way relationship in the perspective of diabetologist.
abstract: Diabetes is a risk factor for pancreatic cancer as roughly half of all patients with pancreatic cancer are found to have diabetes at time of diagnosis. Moreover, an around 2-fold risk of pancreatic malignancy in diabetic patients has even be recently resulted from two meta-analysis. Actually, there is a bidirectional association between the two entities that implies a complex and reverse causality. In fact, while the risk for pancreatic cancer is modestly but significantly increased in patients with long-standing diabetes, recent-onset diabetes appears to be very frequently associated with pancreatic malignancy. Therefore, diabetes could serve as an excellent clue for early detection of pancreatic cancer. Moreover, recent epidemiological findings support the hypothesis that chronic exposure to hyperglycemia, higher insulin concentrations, and insulin resistance may be responsible for the enhanced risk of developing pancreatic cancer. Epidemiological data suggest that the type of anti-diabetic therapy may affect the risk of developing pancreatic cancer. In particular, metformin has been shown to reduce the risk of pancreatic cancer, as well as several other malignancies. On the other hand, some hypoglycemic agents could determine an increase of pancreatic cancer risk. These last findings were not confirmed. Finally, pancreatic cancer necessitates of a multidisciplinary management, primarily including surgeons and oncologists. In this context, the diabetologist plays an important role, given that his actions may influence the prevention and early diagnosis of pancreatic cancer, the perioperative complications associated to glycemic derangement, as well as the proper treatment of postpancreactomy diabetes.
authors.affiliation: Depart. of Internal and Experimental Medicine "Magrassi - Lanzara", Second University of Naples, Italy. Electronic address: teresa.salvatore@unina2.it.
authors.forename: Teresa
authors.initials: T
authors.lastname: Salvatore
authors.affiliation: Depart. of Medicine, Surgery, Neurology, Metabolism and Geriatrics, Second University of Naples, Italy. Electronic address: raffaele.marfella@unina2.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Marfella
authors.affiliation: Depart. of Medicine, Surgery, Neurology, Metabolism and Geriatrics, Second University of Naples, Italy. Electronic address: mariarosaria.rizzo@unina2.it.
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Rizzo
authors.affiliation: Depart. of Internal and Experimental Medicine "Magrassi - Lanzara", Second University of Naples, Italy. Electronic address: ferdinando.sasso@unina2.it.
authors.forename: Ferdinando Carlo
authors.initials: FC
authors.lastname: Sasso
mesh_terms: D001786:Blood Glucose / Q000502:physiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007333:Insulin Resistance / Q000502:physiology; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000601:surgery; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents
keywords: Diabetes; Hypoglycemic agents; Insulin; Pancreatic cancer