Pancreatic cancer-related diabetes mellitus: A retrospective investigation of clinical characteristics and relationship with the prognosis

Abstract Background The bidirectional association between pancreatic cancer (PaC) and diabetes mellitus (DM) is well-established. PaC-related DM (PRDM) is characterized by low insulin secretion and insulin resistance. Aims To investigate the diabetic state and PRDM, and assess whether these markers have predictive value for survival in patients with PaC. Methods We retrospectively examined the clinical factors, glucagon stimulation test results, and homeostasis model assessment of insulin resistance (HOMA-IR) scores in patients with PaC. PRDM was defined as if fasting blood glucose was ≥ 126 mg/dL or if hemoglobin A1c (HbA1c) was ≥ 6.5%. We reviewed new-onset PRDM without diabetes treatment history. Increments in C-peptide levels after glucagon stimulation (ΔC-peptide) was examined. Kaplan–Meier curves and log-rank tests were used for data analysis. Results The ΔC-peptide value was ≥ 1 ng/ml in 77.3% of the patients with PaC, of which 13.8% demonstrated a HOMA-IR score > 2.5 and 42.2% of them showed PRDM. The presence of PRDM was significantly shorter overall survival (OS). Patients with ΔC-peptide < 1ng/ml did not show significantly shorter OS than those with ≥ 1 ng/ml (median, 546 [95%CI, 373–900] vs. 567 [514–772] days, p = 0.59). The group with HOMA-IR ≥ 2.5 also did not show a significantly shorter median OS than the group with HOMA-IR < 2.5 (median, 371 [528–710] vs. 571 [221–954] days, p = 0.068) Conclusions The ΔC-peptide values and HOMA-IR score were not significant predictors of survival although PRDM could be related with prognosis.