Introduction
People with diabetes have a higher risk of conditions like infections and cancer. They are more prone to pancreatic cancer. Studies show that eighty percent of people with pancreatic cancer are intolerant to glucose or have diabetes. This has led to a detailed study to unveil the hidden link between the two conditions. This article deals with the same.
What Is Diabetes?
A chronic condition in which blood glucose levels are always high is termed diabetes. This can be either due to an insufficient supply of insulin or to the body's inefficiency in using insulin appropriately. In the long run, having high levels of glucose in the blood can cause other health concerns, like heart disease, nerve damage, eye problems, and kidney disease.
What Is Pancreatic Cancer?
Pancreatic cancer is a condition in which abnormal cells form in the pancreas, grow, and multiply uncontrollably. The pancreas is a small organ located deep in the abdomen, between the stomach and the spinal cord. It secretes insulin and helps regulate the body’s blood sugar levels.
Many similar cells group together to form organs like the pancreas. The cells multiply in a controlled manner, causing growth. As the cells get old, they die and are replaced by new ones. However, in some conditions, this process becomes disrupted. New cells might be formed when the body does not need them, or the old cells fail to die at the usual time. These abnormal cells clog together and form a tumor' mass. Some tumors do not spread to other body parts and are called benign tumors. On the other hand, some tumors spread to various places, even to distant parts of the body. These are termed ‘cancerous’ or ‘malignant’ tumors; the cells are termed cancer cells.
What Are the Symptoms of Pancreatic Cancer?
The early signs of pancreatic cancer can include:
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Frequent abdominal and back pain.
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Weight loss.
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Jaundice (yellowing of the skin and the white of the eyes).
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Itching may or may not be present.
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Nausea.
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Loss of appetite.
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Swollen pancreas (pancreatitis).
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Changes in the consistency or texture of stool.
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Bloating.
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Recent onset of diabetes.
How Is Diabetes and Pancreatic Cancer Linked?
The pancreas produces insulin, which breaks down glucose and provides energy for the body. This hormone regulates blood sugar levels. However, if the organ becomes cancerous, it can affect the tissues, interfering with insulin production. This can lead to an overall state of diabetes.
The normal blood sugar levels in a healthy individual can range from 70 mg/dL (3.9 mmol/L) to 100 mg/dL (5.6 mmol/L). The fasting blood sugar levels should be between 70 to 99 mg/dL (3.9 and 5.5 mmol/L) in a normal human being. The blood sugar levels after eating food should be below 140 mg/dL (7.8 mmol/L). Blood sugar levels higher than these values can indicate the onset of diabetes. When the blood sugar ranges between 100 to 125 mg/dL (5.6 to 6.9 mmol/L), the patient is considered pre-diabetic. A blood sugar level of 26 mg/dL (7.0 mmol/L ) two consecutive times, or higher blood sugar values, can indicate that a patient is diabetic.
Healthcare experts recommend screening for pancreatic cancer from the time when a patient receives the diagnosis of diabetes. The diagnosis of diabetes can be confirmed when a person’s glycated hemoglobin (HbA1c) levels are 6.5% or higher. The first three years after the diagnosis is called new-onset diabetes. The risk of developing pancreatic cancer is the highest during this period. It later drops and is among the levels of risk in an established diabetic person.
What Is Type 3C Diabetes?
There are two types of diabetes, type 1 and type 2. The former is a condition where the pancreas secretes little or no insulin, while in the latter, the body is unable to use the insulin produced effectively (insulin resistance). Type 3c is an entirely different entity and is managed differently. It is caused by some damage in the pancreas and is also called pancreatogenic diabetes or brittle diabetes.
Type 3c diabetes is common in people with pancreatic cancer. Other conditions where it occurs can include pancreatitis (inflammation of the pancreas), and people who have undergone some surgery in their pancreas. It is also seen in people who have undergone a total pancreatectomy (complete removal of the pancreas).
In type 3c diabetes, the body does not produce sufficient levels of insulin or glucagon (a peptide hormone secreted by the Islets of Langerhans in the pancreas). In type 1 diabetes, the body produces less or no insulin but normal glucagon levels. On the other hand, in type 3c, insulin and glucagon are not produced at sufficient levels. In type 2 diabetes, the body produces sufficient insulin levels, but the body cannot utilize it efficiently. On the contrary, in type 3c, the body can use insulin efficiently but does not produce it sufficiently. In a person who has undergone total pancreatectomy, insulin and glucagon might not be produced.
Is Digestion Affected in Pancreatic Cancer?
People with type 3c diabetes might have issues digesting their food properly. All the enzymes that help digestion might also be altered or inefficient in pancreatic cancer. As a result, the food remains indigested. Capsules that can replace these enzymes (called pancreatic enzyme replacement therapy (PERT) are given to these people.
As the enzymes are administered, the carbohydrates in the food get digested, raising blood sugar levels more than when the enzymes were absent. Hence, regular blood sugar levels and food consumption monitoring should be maintained. The diabetic medication might also need to be altered depending on the patient’s needs.
Conclusion
Although clinical trials done recently have unveiled the link between pancreatic cancer and diabetes, how to manage them appropriately needs to be understood. Healthcare providers must develop proper screening guidelines for pancreatic cancer following new-onset diabetes. These guidelines should be formed and maintained regularly so that the patients get an earlier diagnosis and appropriate management for the cancer. While this can be rare, it is important to be aware of the connections rather than ignorant.
