Diabetes: risk factor of pancreatic cancer

Signs and Symptoms

• Urinating more often than usual, particularly at night
• Feeling very thirsty
• Feeling very tired/fatigued
• Unexplained weight loss
• Itching around the penis or vagina
• Slow wound healing
• Blurred vision
• Increased hunger

Types of Diabetes

Type 1:

This type is usually diagnosed in children and young adults, but it can develop at any age. Although certain genes can play a role in type 1 diabetes, they are not the only factors involved. It is an autoimmune condition, where the body’s immune system mistakenly attacks insulin-producing cells, meaning that not enough insulin is produced. Those with type 1 diabetes are insulin-dependent.

Type 2:

This is the most common type of diabetes. It may develop slowly, usually over the age of 40. The pancreas no longer produces enough insulin or has become resilient to insulin. This type of diabetes is caused by behaviour and lifestyle choices e.g. lack of exercise, unhealthy diet.

Type 3:

This type is common following pancreatic surgery when all or part of the pancreas has been removed, therefore less able to produce insulin. This often leads to increased complications and greater dependence on insulin. Find out more about type-3 diabetes here.

Gestational Diabetes:

This type of diabetes occurs within pregnancy when the body cannot meet the insulin needs of both the baby and the mother and disappears following the birth of the baby. Not all expectant mothers will experience this, but it affects 4-5 out of 100 women during pregnancy.

Risk for pancreatic cancer

Insulin resistance and raised blood sugar levels in type 2 diabetes cause inflammation which damages the pancreas. In the long term, this may increase the risk of pancreatic cancer. The relationship between pancreatic cancer and diabetes is complex as Type 2 acts as both a cause for and response to pancreatic cancer.

To find out more about diabetes, you may find this video “Diabetes: The Basics” from Diabetes UK helpful.

New-onset Diabetes and Pancreatic Cancer

After years of campaigning, funding research and lobbying, Pancreatic Cancer Action achieved a significant change to NICE guidance that has the potential to save up to 3,000 lives a year.

NICE Guidance (NG17) covering the management and diagnosis of diabetes in adults was updated to include advice to help identify pancreatic cancer. This reads:

For people aged 60 and over presenting with weight loss and new-onset diabetes, follow recommendations on assessing for pancreatic cancer in the section on pancreatic cancer in the NICE guideline on suspected cancer: recognition and referral. [2022]

This means that patients should be referred for an urgent direct access CT scan (to be done within two weeks), or an urgent ultrasound scan if CT is not available, to assess for pancreatic cancer in people aged 60 and over with weight loss and new-onset diabetes.

Research shows that new-onset diabetes has been identified to occur in up to 30% of pancreatic cancer patients and is something that can be detected in the presymptomatic phase. In some cases, this can be up to two years before the cancer is discovered. Type 2 diabetes is a symptom of pancreatic cancer, especially for those with a low or reducing BMI.

Pancreatic cancer is the deadliest of all the common cancers. In England, only 25/4% of pancreatic cancer patients survive one year after diagnosis and only 7.3% survive five years after diagnosis. Only around 10% can have surgery to remove pancreatic cancer due to the late stage it is diagnosed. This change in guidance will result in potentially thousands more being diagnosed for life saving surgery.