Risk for pancreatic cancer rises with fasting glucose, regardless of diabetes status
In a large cohort of Korean adults, the cumulative incidence rate for pancreatic cancer increased with fasting glucose level, even in people without diabetes, according to database analysis published in The Journal of Clinical Endocrinology & Metabolism.
“Diabetes is one of the established risk factors for pancreatic cancer,” Cheol-Young Park, MD, PhD, of Kangbuk Samsung Hospital in Seoul, Korea, said in a press release. “When we evaluated the pancreatic cancer incidence according to fasting glucose levels using a national cohort database, we found the number of pancreatic cancer cases rose as fasting glucose levels increased. This was true in people who had diabetes as well as those who did not.”
Koo and colleagues analyzed data from 25.4 million patients who participated in a health exam between 2009 and 2013, using data from the National Health Insurance Service. Researchers evaluated pancreatic cancer incidence rates according to fasting glucose level. Cumulative incidence rate for pancreatic cancer was calculated after grouping patients according to low-normal (< 90 mg/dL), high-normal (90-99 mg/dL), prediabetes level 1 (100-109 mg/dL), prediabetes level 2 (110-125 mg/dL), type 2 diabetes ( 126 mg/dL) and type 2 diabetes on antidiabetic medications.
During 116,995,600 person-years of follow-up (median follow-up, 5.45 years), researchers identified 11,429 new cases of pancreatic cancer. Researchers found that the risk for pancreatic cancer increased continuously with elevating fasting glucose levels (P < .0001).
The 5-year cumulative incidence rates (per 100,000) were 32 for low-normal (95% CI, 31-33), 41 for high-normal (95% CI, 40-43), 50 for prediabetes level 1 (95% CI, 47-52), 64 for prediabetes level 2 (95% CI, 60-68), 75 for type 2 diabetes (95% CI, 69-82) and 121 for patients prescribed antidiabetes medications (95% CI, 116-127).
Results persisted after adjusting for age, sex, smoking status, drinking, physical activity level, BMI and diabetes duration (P < .0001).
In analyses investigating the relationship between the diabetes duration and pancreatic cancer, researchers observed a J-shaped association. There was no significant difference in the incidence of pancreatic cancer between the patients who received insulin and those who did not among populations treated with antidiabetic medications, according to researchers.
“Since two previous randomized trials have shown that a lifestyle intervention could decrease fasting glucose levels and reduce the risk of diabetes, early detection of hyperglycemia in preventive health checkups could offer a critical opportunity for lowering the risk of pancreatic cancer,” the researchers wrote. “Therefore, efforts made toward early detection of hyperglycemia and lifestyle modification to improve glucose profile may provide a practical strategy to reduce the increasing risk of pancreatic cancer.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.