Blood sugar, diabetes offer clues about pancreatic cancer

Volume 7, Issue 4, 2018


Patients with high blood sugar and a high ENDPAC score should be tested for pancreatic cancer.

Suresh T. Chari, M.D.

Suresh T. Chari, M.D.

Patients diagnosed with pancreatic cancer can develop elevated blood sugar levels up to three years before their cancer diagnosis, according to the results of two studies by Mayo Clinic researchers published in the journal Gastroenterology.

"Pancreatic cancer is rapidly fatal after its diagnosis, with average survival of six months," said Suresh T. Chari, M.D., a gastroenterologist at Mayo Clinic in Rochester, Minnesota. "It has also been thought that its course prior to diagnosis is also rapid and that early detection is not feasible. But our studies provide hope that pancreatic cancer can indeed be diagnosed at an earlier stage when it is resectable."

In the first study, researchers plotted blood sugar levels of patients with pancreatic cancer going back five years prior to diagnosis. They also plotted the blood sugars of a control group of patients who were age-matched and gender-matched to the patients with pancreatic cancer. In this group, researchers were able to show that blood sugars rise 30 to 36 months before the diagnosis of cancer.

In another group of patients and controls, researchers plotted blood sugars of nearly 600 patients with pancreatic cancer just prior to surgical removal of the cancer. Researchers grouped these patients by their tumor volume at the time of the surgical removal. "In this group, we were able to show that blood sugars rise commensurate with the increasing volume of the tumor. Patients with tumors that were very small — less than 1 cubic centimeter in volume — had lower blood sugars than did patients with larger tumors," Dr. Chari said.

In the second study, also published in Gastroenterology, Mayo Clinic researchers describe a risk-prediction model that identifies patients with new-onset diabetes who are at very high risk of developing pancreatic cancer.

Researchers say the findings reported in the two studies are significant because they represent a potential new way to diagnose pancreatic cancer at an earlier stage.

The model, called an ENDPAC score, identifies a subset of patients with new-onset diabetes who have a 30-fold to 40-fold higher risk of having pancreatic cancer. "Among these patients, the risk of having pancreatic cancer is between 4 and 7 percent," Dr. Chari said. "We believe that if these findings are validated, patients who have a high blood sugar level and a high ENDPAC score should be thoroughly tested for pancreatic cancer."