Association between Diabetes Mellitus and Pancreatic Cancer: A Comprehensive Narrative Review

Abstract

Pancreatic cancer (PC) is extremely aggressive, with symptoms occurring only in the advanced stage. The relationship between Type 2 Diabetes Mellitus (T2DM) and PC is complex. However, it is unclear whether long-standing diabetes causes cancer or whether cancer proceeds the development of impaired glucose metabolism. PubMed, Google Scholar, Scopus and Cochrane library were consulted to look for relevant literature. We narrowed down 20 articles after implementing inclusion and exclusion criteria. The database was searched using the keywords “Pancreatic Cancer” AND “Diabetes Mellitus.” This narrative literature review aims to analyze the literature on the analysis of the metabolic association of T2DM, the risk of carcinogenesis of the pancreas and their association, and the current understanding of metabolic pathways involved in cellular growth and metabolism. About 80% of patients with pancreatic disease have a previous diagnosis of diabetes within five years. We explored the literature to find metabolic associations between PC and T2DM due to insulin resistance, hyperinsulinemia, hyperglycemia, low-grade chronic inflammation, and insulin-like growth factor axis alteration.