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World J Gastroenterol. Aug 14, 2021; 27(30): 4939-4962
Published online Aug 14, 2021. doi: 10.3748/wjg.v27.i30.4939
Diabetes and pancreatic cancer: Exploring the two-way traffic
Ayan Roy, Jayaprakash Sahoo, Sadishkumar Kamalanathan, Dukhabandhu Naik, Pazhanivel Mohan, Raja Kalayarasan
Ayan Roy, Jayaprakash Sahoo, Sadishkumar Kamalanathan, Dukhabandhu Naik, Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Ayan Roy, Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Jodhpur 342005, India
Pazhanivel Mohan, Department of Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Raja Kalayarasan, Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Author contributions: Roy A, Sahoo J and Mohan P did the literature search; Roy A wrote the first draft of the review; Sahoo J and Kamalanathan S conceptualized the work, supervised the writing, gave intellectual inputs, and critically revised the manuscript; Naik D, Mohan P and Kalayarasan R gave intellectual inputs and critically revised the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jayaprakash Sahoo, MD, DM, Additional Professor, Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Room 5444, 4th Floor, Superspecialty Block, Pondicherry 605006, India. jppgi@yahoo.com
Received: January 28, 2021
Peer-review started: January 28, 2021
First decision: May 2, 2021
Revised: June 16, 2021
Accepted: July 7, 2021
Article in press: July 7, 2021
Published online: August 14, 2021
Abstract

Pancreatic cancer (PC) is often associated with a poor prognosis. Long-standing diabetes mellitus is considered as an important risk factor for its development. This risk can be modified by the use of certain antidiabetic medications. On the other hand, new-onset diabetes can signal towards an underlying PC in the elderly population. Recently, several attempts have been made to develop an effective clinical tool for PC screening using a combination of history of new-onset diabetes and several other clinical and biochemical markers. On the contrary, diabetes affects the survival after treatment for PC. We describe this intimate and complex two-way relationship of diabetes and PC in this review by exploring the underlying pathogenesis.

Keywords: Chronic pancreatitis, Diabetes, New onset diabetes, Pancreatic adenocarcinoma, Pancreatic cancer, Type 3c diabetes

Core Tip: Type 2 diabetes mellitus can increase the risk of pancreatic cancer (PC) and certain antidiabetic medications can modify this risk. New onset diabetes in combination with other clinical and biochemical markers can serve as an effective screening tool for PC. On the contrary, the glycaemic status affects the treatment outcome of PC. More awareness among clinicians is required about the two-way relationship between diabetes mellitus and PC.