Increased Risk of Hospitalization for Pancreatic Cancer in the First 8 Years after a Gestational Diabetes Mellitus regardless of Subsequent Type 2 Diabetes: A Nationwide Population-Based Study

Abstract

The aim of this large retrospective cohort study was to use a quasi-exhaustive national medico-administrative database of deliveries in France to determine the risk of developing pancreatic cancer (PC) in women with a history of gestational diabetes mellitus (GDM). This nationwide population-based study included women aged 14–55 who gave birth between 1st January 2008 and 31 December 2009. The women were followed-up epidemiologically for eight years. Survival analyses using Cox regression models, adjusted for age, subsequent type 2 diabetes, and tobacco consumption, were performed on the time to occurrence of hospitalization for PC. The onset of GDM, tobacco consumption and subsequent type 2 diabetes were considered as time-dependent variables. Among 1,352,560 women included, 95,314 had a history of GDM (7.05%) and 126 women were hospitalized for PC (0.01%). Over the eight years of follow-up, GDM was significantly associated with a higher risk of hospitalization with PC in the first Cox regression model adjusted for age and subsequent type 2 diabetes (HR = 1.81 95% CI [1.06–3.10]). The second Cox regression model adjusted for the same covariates, plus tobacco consumption, showed that GDM was still significantly associated with a higher risk of hospitalization for PC with nearly the same estimated risk (HR = 1.77 95% CI [1.03–3.03]). Gestational diabetes was significantly associated with a greater risk of hospital admission for pancreatic cancer within eight years, regardless of subsequent type 2 diabetes.

Gestational Diabetes Mellitus and Its Correlation in the Development of Pancreatic Cancer: A 10-Year Systematic Review

“…[7] study, and Simon J. 's [7] study did not provide sufficient information on the outcome regarding the correlation between GDM and PC. Both studies received a score of 7 out of 8, suggesting that the quality and validity of their study accurate (Table 4).…”

“…The most common type of pancreatic cancer is pancreatic duct adenocarcinoma (PDAC), which is responsible for 90% of cases worldwide [6]. PC's high mortality rate is attributed both to late diagnosis, since most patients do not develop symptoms until the disease reaches a more advanced stage, and to limited available responses to existing treatments [7].…”

“…For this systematic review, two cohort studies-Peng et al [31] and Simon J. [7]-were examined using the scale of 0 to 7 (0 being the lowest quality and 7 the highest). For the Selection category, both studies clearly stated the goal of their study and included an adequate sample size to support the research they wanted to conduct.…”

“…However, for the Peng et al [31] study, no statistical test was provided in comparison with the Simon J. [7] study, and Simon J. 's [7] study did not provide sufficient information on the outcome regarding the correlation between GDM and PC.…”

Is Gestational Diabetes Mellitus a Risk Factor of Maternal Breast Cancer? A Systematic Review of the Literature

“…In addition, GDM shares underlying mechanisms with type 2 diabetes, including hyperglycemia due to pancreatic β-cell dysfunction coupled with insulin resistance and hyperinsulinemia. It is therefore possible that GDM may be associated with an increased risk of cancer [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ], including BC.…”