Diseases of the exocrine pancreas can result in impaired function of the endocrine pancreas with disturbed glucose homeostasis and ultimately overt diabetes mellitus. In diabetes which develops secondary to pancreatic carcinoma (type 3c diabetes or diabetes of the exocrine pancreas, DEP), the relationship between disturbed glycemic control and carcinoma is not fully understood. We hypothesized that the severity of pancreatic carcinoma positively associates with the degree of impairment of glycemic control. In 92 patients with potentially resectable pancreas neoplasm without diabetes (NOD, n=53, age 67±2 years, BMI 24.8±0.5 kg/m2), DEP (n=20, 71±3 years, 25.3±1.0 kg/m2) or preexisting type 2 diabetes (T2D, n=19, 71±3 years, 27.1±0.8 kg/m2), preoperative fasting glucose, insulin and HbA1c were measured. Pancreatic carcinoma was assessed by TNM classification and tumor grading. Patients with DEP or T2D had higher fasting glycemia (135±9 vs. 142±11 mg/dl), HbA1c (55±3 vs. 58±3 mmol/mol) and insulin resistance, as assessed by homeostatic model assessment for insulin resistance (HOMA-IR) (4.1±1.0 vs. 3.7±0.5), than NOD patients (88±2 mg/dl, 38±1 mmol/mol, 2.0 ± 0.3; all p<0.01). Tumor grading revealed that patients with tumor grade G3 had higher levels of fasting glucose (124±36 mg/dl) and HbA1c (53±2 mmol/mol) compared to patients with non-malignant neoplastic lesions (103±38 mg/dl, 42±2 mmol/mol; all p<0.01). Distribution patterns of tumor grades differed between DEP and T2D (p<0.05) and NOD (p<0.001), respectively. Particularly, the prevalence of G3 tumors was higher in DEP (79%) than in T2D (33%) or NOD patients (16%). Tumor stages did not relate to glycemic control.

In conclusion, patients with pancreas carcinoma exhibit a higher diabetes prevalence, which relates to higher tumor grades but not stages.


J. Boeddeker: None. V. Burkart: None. K. Strassburger: None. P.E. Goretzki: None. W. Knoefel: None. C. Moebius: None. N. Hinsch: None. I. Esposito: None. M. Roden: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Poxel SA, Servier. Board Member; Self; Eli Lilly and Company. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Sanofi. Speaker's Bureau; Self; Novo Nordisk Inc. K. Muessig: None.


German Ministry of Culture and Science of the State of North Rhine-Westphalia; German Federal Ministry of Health; German Federal Ministry of Education and Research; German Center for Diabetes Research

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