Pancreatogenic Diabetes: Special Considerations for Management

Cui, Yun Feng; Andersen, Dana K.

doi:10.1159/000329188

Cited by 223 publications

(226 citation statements)

References 93 publications

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“…DM is a group of metabolic disorders characterized by hyperglycemia. The three most common subtypes of DM differ greatly in their metabolic and hormonal characteristics, however (Table 1; Cui & Andersen 2011). T1DM is associated with a profound or absolute deficiency of endogenous insulin secretion and an absolute requirement for exogenous insulin administration.…”

Section: Diabetes (And Obesity) As a Cause Of Pcmentioning

confidence: 99%

“…Hyperglycemia and hyperinsulinemia coexist in T2DM due to insulin resistance in peripheral tissues usually in association with obesity. T3cDM is associated with benign and malignant disease of the exocrine pancreas, including acute and CP of any etiology, pancreatic neoplasms, pancreatic trauma, pancreatic resection, cystic fibrosis, hemochromatosis, fibrocalculous pancreatopathy, and pancreatic agenesis and is characterized by a severe deficiency of all pancreatic glucoregulatory hormones (American Diabetes Association 2011, Cui & Andersen 2011).…”

Section: Diabetes (And Obesity) As a Cause Of Pcmentioning

confidence: 99%

“…T3cDM has emerged as a major subset of the total population of DM and harbors the highest risk of PC especially in patients with T3cDM secondary to CP (Cui & Andersen 2011). Persons with any form of CP are at increased risk of developing PC, and Lowenfels et al (1993) observed that the risk is cumulative over the course of CP, such that 4-5% of patients develop PC over the course of 20 years, a risk that is 10-20 times greater than the general population.…”

Section: Diabetes (And Obesity) As a Cause Of Pcmentioning

confidence: 99%

“…Although subject to multiple methodological limitations, these findings nevertheless raise concerns regarding an increased risk for pancreatitis and PC with GLP1-based therapy. Further epidemiological studies are clearly needed to define the possible hazards of incretin-based antidiabetic therapy, particularly in patients with T3cDM due to CP (Cui & Andersen 2011). …”

Section: Proposed Mechanisms Of Diabetes-related Pancreatic Carcinogementioning

confidence: 99%

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Diabetes and pancreatic cancer

Cui¹,

Andersen²

2012

Endocrine-Related Cancer

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128

102

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Epidemiological studies clearly indicate that the risk of pancreatic cancer (PC) is increased in diabetic patients, but most studies focus on overall diabetes or type 2 diabetes mellitus (T2DM), and there are few studies on the risks of type 1 and type 3c (secondary) diabetes. Possible mechanisms for increased cancer risk in diabetes include cellular proliferative effects of hyperglycemia, hyperinsulinemia, and abnormalities in insulin/IGF receptor pathways. Recently, insulin and insulin secretagogues have been observed to increase the PC risk, while metformin treatment reduces the cancer risk in diabetic subjects. In addition, anticancer drugs used to treat PC may either cause diabetes or worsen coexisting diabetes. T3cDM has emerged as a major subset of diabetes and may have the highest risk of pancreatic carcinoma especially in patients with chronic pancreatitis. T3cDM is also a consequence of PC in at least 30% of patients. Distinguishing T3cDM from the more prevalent T2DM among new-onset diabetic patients can be aided by an assessment of clinical features and confirmed by finding a deficiency in postprandial pancreatic polypeptide release. In conclusion, diabetes and PC have a complex relationship that requires more clinical attention. The risk of developing PC can be reduced by aggressive prevention and treatment of T2DM and obesity and the prompt diagnosis of T3cDM may allow detection of a tumor at a potentially curable stage.

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Section: Diabetes (And Obesity) As a Cause Of Pcmentioning

confidence: 99%

Section: Diabetes (And Obesity) As a Cause Of Pcmentioning

confidence: 99%

Section: Diabetes (And Obesity) As a Cause Of Pcmentioning

confidence: 99%

Section: Proposed Mechanisms Of Diabetes-related Pancreatic Carcinogementioning

confidence: 99%

See 2 more Smart Citations

Diabetes and pancreatic cancer

Cui¹,

Andersen²

2012

Endocrine-Related Cancer

Self Cite

128

102

View full text Add to dashboard Cite

show abstract

“…12 CP patients with different lifestyles, genetic background, clinical manifestations, and medical interventions may have different risks of developing DM. 11,13 Several studies have confirmed alcoholism and distal pancreatectomy as independent risk factors for DM development in CP patients. 3,4 Studies also showed that type 3c DM may share common risk factors with type 1 and type 2 DM.…”

Section: Introductionmentioning

confidence: 99%