Background/Aims-The temporal association between diabetes mellitus and pancreatic cancer is poorly understood. We compared temporal patterns in diabetes prevalence in pancreatic cancer and controls.

Incidence and prevalence of CP are low, and ∼50% are alcohol related. The incidence of CP cases diagnosed during life is increasing. Survival of CP patients is lower than in the Minnesota White population.

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Background Though the association between diabetes mellitus (DM) and pancreatic cancer is well described, temporal patterns of changes in fasting blood glucose (FBG) and body mass index (BMI) before pancreatic cancer diagnosis are not known. Methods We reviewed medical records of pancreatic cancer cases seen at Mayo Clinic from 1/15/1981 through 7/9/2004 and selected those residing within 120 miles of Rochester, Minnesota and seen at Mayo Clinic within 30 days from the date of cancer diagnosis (index date). We identified ~2 matched controls per case residing locally and seen at Mayo in the year of their case’s index date. For the 736 cases and 1,875 controls with at least one outpatient FBG measurement, we abstracted all FBG values and corresponding heights and weights up to 60 months before index and grouped them into 12-month intervals preceding index. We compared FBG and BMI in each interval between cases and controls. Results Mean FBG values were similar between cases, compared to controls, in the −60 to −48 (102 vs. 100 mg/dl, p=0.34), and −48 to −36 month intervals (106 vs. 102 mg/dl, p=0.09); but progressively increased in the −36 to −24 (105 vs. 100 mg/dl, p=0.01), −24 to −12 (114 vs. 102 mg/dl, p=0.001), and −12 to +1 (123 vs. 102 mg/dl, p<.0001) month intervals. Though mean BMI values were generally similar in cases and controls up to 12 months before index, they were significantly lower in cases vs controls in the −12 to +1 (p<.001) month intervals. Conclusions Pancreatic cancer is characterized by progressive hyperglycemia beginning up to 24 months before cancer diagnosis in the setting of decreasing BMI. Pancreatic cancer can potentially be diagnosed early if biomarkers are identified that can distinguish pancreatic cancer-induced DM from type 2 DM.

Our study suggests that CP at a population level may have a milder course than that reported from tertiary centers. We confirm that ACP has a more severe phenotype than NACP.