Naslov
Diabetes mellitus in pancreatic cancer

Autori
Štimac, Davor

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, neobjavljeni rad, stručni

Skup
6. Croatian Endocrinological congress with international participation

Mjesto i datum
Poreč, Hrvatska, 09.10.2013. - 13.10.2013

Vrsta sudjelovanja
Demonstracija

Vrsta recenzije
Nije recenziran

Ključne riječi
pankreatogena šećerna bolest; karcinom gušterače; HbA1c; metformin
(pancreatogenic diabetes mellitus; pancreatic cancer; HbA1c; metformin)

Sažetak
Although diabetes mellitus (DM) and pancreatic cancer (PaC) arise from two separate parts of the pancreas (endocrine and exocrine part respectively), the two entities are linked one to the other. Newly acquired diabetes is often the first symptom of PaC (around 25% of cases), the same way PaC can be found more often in patients suffering from DM (RR=1.94, 95% CI=1.66-2.27). The hallmarks of PaC, including early spread, late symptoms and mostly ineffective therapy, warrant an agressive approach in screening high-risk patients in an attempt of discovering the disease in the early stage. Distinguishing type 2 from type 3c (pancreatogenic) DM seems to be of the utmost importance, as newly acquired type 3c DM represents a warning sign implicating PaC as a possible cause. The diagnosis of PaC is usually made 3-6 months after the onset of DM. The main disadvantage is that there are no established protocols for diagnosing type 3c DM ; deficiency of the pancreatic polypeptide response to ingested nutrients seems to be the best marker for type 3c DM. Molecular mechanisms that induce carcinogenesis are also only partially understood. The main focus is on the anabolic effects of insulin mediated through insulin receptor and insulin-like growth factor 1 receptor, conferring the signal through the m-TOR pathway, inducing procarcinogenic celullar activity. Insulin resistance seems to have the most pronounced effect, as obese type 2 DM patients have the highest risk of acquiring PaC among the different DM patient groups. The effect of antidiabetic medications on PaC epidemiology shows a pattern. Insulin and insulin secretagogues (sulphonylurea-based compounds) show an increased risk of acquiring PaC, as opposed to a lower risk when using insulin sensitisers (metformin). The results are still controversial, especially with regards to insulin, as patients on insulin therapy tend to have a more advanced disease.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

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