It is a well-established fact that type 2 diabetes is among the major risk factors for pancreatic cancer. Even though type 2 diabetes often will go along with weight gain; pancreatogenic diabetes can paradoxically be accompanied by weight loss as well. A recent publication in JAMA Oncology by Yuan et al reports that individuals with recent-onset diabetes followed by a weight loss are prone to high risk for developing pancreatic cancer.
The cohort study obtained data from female participants in the Nurses’ Health Study and male participants in the Health Professionals Follow-Up Study, with repeated exposure assessments over 30 years. Incident cases of pancreatic cancer were recognized from self-report or during follow-up of participant deaths. The major findings were that from among the 112 818 women (with a mean [SD] age of 59.4 [11.7] years) and 46 207 men (with a mean [SD] age of 64.7 [10.8] years), there were 1116 incident cases of pancreatic cancers. Participants with recent-onset diabetes had an age-adjusted HR for pancreatic cancer of 2.97 (95% CI, 2.31-3.82) compared to participants with no diabetes, and those with long-standing diabetes had an age-adjusted HR of 2.16 (95% CI, 1.78-2.60). Also, when compared to those with no weight loss, participants who reported a 1- to 4-lb weight loss had an age-adjusted HR for pancreatic cancer of 1.25 (95% CI, 1.03-1.52), those with a 5- to 8-lb weight loss had an age-adjusted HR of 1.33 (95% CI, 1.06-1.66), and those with more than an 8-lb weight loss had an age-adjusted HR of 1.92 (95% CI, 1.58-2.32). The incidence rates were found to be even higher among participants with recent-onset diabetes and weight loss with a body mass index of less than 25 before weight loss (400 incident cases per 100 000 person-years) or whose weight loss was not intentional judging from increased physical activity or healthier dietary choices (334 incident cases per 100 000 person-years).
The study concluded that recent-onset diabetes accompanied by weight loss considerably increases the risk for developing pancreatic cancer. Old age, previous healthy weight, and no intentional weight loss further advance the risk.