Determining the difference between type 2 and type 3c diabetes

A retrospective study profiling patients who would benefit from pancreatic cancer diagnostic tests to aid early diagnosis.

What is this study?

In partnership with the University of Surrey, this research project would be a retrospective case control study (looking back at existing patients with and without a condition). The project involves examining the GP records of patients with diabetes who went onto develop pancreatic cancer and those who did not develop the disease. Records will be taken from the RCGP database where approximately 9.5 million patients’ data are stored. This allows a large sample of patients to investigate.

The study will compare the records of patients to find any differences in their demographics such as BMI and age. Comparisons can also be made in patients’ journeys, both in the control and development of their diabetes, and other symptoms presented at GP appointments.

Findings of the study will be reported in the form of a research paper, aiming to be published in a peer reviewed journal.

Why carry out research in this area?

Evidence into the link between diabetes and pancreatic cancer is building. Studies predict that 50% of patients diagnosed with pancreatic cancer, have a prior diagnosis of diabetes and another 30% have impaired glucose called prediabetes. It is predicted that many cases of diabetes in patients who go on to develop pancreatic cancer are misdiagnosed or missed altogether.

Confirming the link between diabetes and pancreatic cancer may help to inform referral guidelines for pancreatic cancer and help medical professionals to identify patients who would benefit from diagnostics, screening or monitoring.

The link between diabetes and pancreatic cancer is not well understood and type 3c diabetes is often misdiagnosed as type 2 in patients with early-stage pancreatic cancer. The study aims to identify differences in the journey of patients with diabetes who go onto develop pancreatic cancer and those that do not. This may help doctors differentiate between the two diseases. This, in turn, will better identify patients whose condition is caused by damage to the pancreas and who need further investigation.  

Furthermore, research into individual patient pathways may reveal a pattern of symptoms presenting around or after the time of diabetes diagnosis that will help to guide pancreatic cancer referral.

How will this research benefit patients?

The aim of this research is to identify possible routes for early diagnosis of pancreatic cancer. Diabetes can develop in pancreatic cancer patients up to 36 months prior to diagnosis and before any other symptoms emerge. Correctly identifying patients with type 3c diabetes and referring promptly could increase early stage diagnosis of pancreatic cancer and therefore survival. Identifying a pattern of symptoms patients present with alongside diabetes could also help to develop a profile of patients who would benefit from referral.

This study will also be used as supportive evidence in other diabetes and pancreatic cancer project funded by PCA. Conclusions drawn from this study may help to inform study design and immediately benefit patients taking part in a second prospective study.