Lower plasma levels of glucose-dependent insulinotropic peptide (GIP) and pancreatic polypeptide (PP) in patients with ductal adenocarcinoma of the pancreas and their relation to the presence of impaired glucoregulation and weight loss

Pancreatic Carcinoma and Diabetes Mellitus

“…These facts suggest that the lower level of leptin and the higher level of adiponectin are a compensatory response of the human body itself to the tumor process. Škrha et al [22] found these differences in advanced-stage PaC cases, thus confirming this theory. One of the limitations of their study is that they lack data from early-stage PaC cases.…”

“…It has been proved that there is a disparity between PaCDM and T2DM in the serum levels of neuroendocrine mediators: the mean plasma level of leptin, pancreatic polypeptide (PP) and glucosedependent insulinotropic peptide (GIP) is significantly lower in PaCDM than that in T2DM, and the level of adiponectin is higher. This significance is more explicit if the PaCDM group is further restricted to patients with new-onset DM and >2kg weight loss compared to the "simple" T2DM cases [22]. The lower serum levels of GIP and PP were present among PaC patients with normal glucose tolerance, suggesting that these findings are rather the consequence of PaC only.…”

“…The investigation by Lee et al strengthens the findings above with additional alarm signs: PaCDM patients were older and had more weight loss, lower premorbid BMI, more family history of PaC and less family history of DM compared to the new-onset T2DM patients. With regard to insulin resistance (IR), the two groups exhibited further differences, which are confirmed by the homeostatic model assessment index: IR is lower in PaCDM than in T2DM [21], and its level is similar to that of the normal healthy population [22]. Unfortunately, it is not sufficient to find a relatively small subgroup based on clinical manifestations of tumors eligible for screening if we cannot precisely differentiate between ill and healthy individuals.…”

“…In a study by Basso et al, daily intraperitoneal injection of supernatant from pancreatic cancer cell line MIA PaCa2 into immunodeficient mice led to a significant increase in blood glucose levels and significantly reduced glucose tolerance compared to control mice injected with saline. The 14 amino acid peptide from S100A8 impairs the catabolism of glucose with myoblasts in vitro and may cause hyperglycemia in vivo [17,22,[24][25][26]. The investigation of complex connections between PaC and DM resulted in an important question: does antidiabetic therapy influence the tumor development/process, and if so, how?…”

Diabetes Mellitus in the Middle-Aged and Elderly Population (>45 Years) and Its Association With Pancreatic Cancer: An Updated Review

“…Among the included articles, four studies explained that LTDM is an independent risk factor for PC [5,7,8,9]. Seven studies showed that NOD precedes the onset of PC [9][10][11][12][18][19][20], and 13 studies proposed as to how NOD with certain clinical factors and screening tests can be used as a predictor for PC screening [1,7,12,14,16,18,19,[21][22][23][24][25][26][27]. Seven studies mentioned the relation between PC and DM after pancreatic surgery [28][29][30][31][32][33][34].…”