Abnormal Carbohydrate Metabolism in Pancreatic Carcinoma

The association between carcinoma of the pancreas and diabetes mellitus

“…Although in the present series there is a slight female preponderance, in a rather similar series of 251 patients reported from the Lahey Clinic (Murphy and Smith, 1963) approximately 70 per cent of the patients were males. However, in both series the sex ratios were the same whether or not there was a disturbance of carbohydrate metabolism present.…”

Carbohydrate Tolerance and Insulin Responses in Obstructive Jaundice

“…Delayed absorption of glucose as well as a nonspecific effect of jaundice on carbohydrate tolerance (Berkowitz et al, 1966) must also be considered in explaining the high proportion of abnormal results. In previous work (Murphy and Smith, 1963;Braganza and Howat, 1972) a high prevalence of diabetic responses to G.T.T.s was reported in patients with carcinoma of the pancreas but it was not made clear whether patients were already jaun-diced when investigated. Our study suggests that patients with obstructive jaundice from causes other than carcinoma of the pancreas are just as likely to have a diabetic response to the G.T.T.…”

“…Gall stones and carcinoma of the pancreas account for most cases but various other conditions such as drug-induced cholestasis or hepatitis may be responsible. Abnormal glucose tolerance has -been reported in 37% to 50% of patients with carcinoma of the pancreas (Murphy and Smith, 1963;Braganza and Howat, 1972) while other -workers have shown a flat insulin response to glucose (McKiddie et at., 1969). According to Malins (1968) and Truelove and Reynell (1972) glycosuria and an albnormal glucose tolerance in a patient with obstructi:ve jaundice favour a diagnosis of carcinoma of the pancreas.…”

Abnormal Differentiation of Islet Cells in Pancreatic Cancer

“…According to clinical and epidemiological studies this glucose metabolic abnormality occurs shortly before the clinical manifestation of the disease [1][2][3] and has been suggested to be a symptom of pancreatic cancer. In particular, reduced serum insulin and the elevation of amylin has been found to be a specific marker for pancreatic cancer [18][19][20]. The underlying mechanism, however, is obscure.…”