Diabetes mellitus negatively influences pancreatic cancer outcomes

In pancreatic cancer patients undergoing chemotherapy, the presence of diabetes mellitus is associated with reduced survival and larger tumour, as well as with increased risk of death after treatment, according to a meta-analysis.

Researchers searched multiple online databases for studies evaluating the prognostic impact of diabetes on the clinical outcome of patients with pancreatic cancer following adjuvant chemotherapy. The regimens of chemotherapy and glucose-lowering medications used in the studies were not limited.

The meta-analysis included six case-control studies comprising 4,241 pancreatic cancer patients (median age, >55 years), among whom 1,034 had diabetes. Pancreatic cancer status was advanced or locally advanced, and gemcitabine-based regimens were frequently used for chemotherapy. Diabetes mellitus was either type 1 or type 2, with most patients treated with insulin and metformin.

Pooled data, obtained using a fixed model, revealed significant differences between diabetic pancreatic cancer patients and their nondiabetic counterparts. Specifically, diabetes exerted a negative effect on overall survival (hazard ratio, 1.16, 95 percent CI, 1.08–1.25; p=0.000) and T stage (odds ratio [OR], 1.30, 1.08–2.17; p=0.005) following chemotherapy.

On the other hand, there were no significant between-group differences in gender (OR, 1.23, 1.00–1.50; p=0.051), tumour locations (OR, 1.13, 0.81–1.56; p=0.476), cancer extent (OR, 0.85, 0.48–1.50; p=0.569), N stage (OR, 1.01, 0.58–1.74; p=0.973) and M stage (OR, 0.64, 0.21–1.99; p=0.441).

According to the researchers, further research is warranted to explore the biological mechanisms underlying the present observations, which may offer new opportunities for diagnosis and therapy in pancreatic cancer and diabetes mellitus patients.