Many patients with exocrine pancreatic cancer develop diabetes mellitus due to insulin resistance. This may relate to concurrent over-production of islet amyloid polypeptide (IAPP) by the pancreatic beta cells. We investigated the effects of pancreatic cancer on circulating IAPP and glucose homeostasis in azaserine-treated rats (developing acinar pancreatic tumours) and BOP-treated hamsters (developing ductular pancreatic tumours). Glucose, insulin and IAPP levels in plasma were neither affected in azaserine-only treated rats nor in animals with enhanced carcinogenesis after chronic caerulein treatment. Azaserine-treated rats on a high-fat diet had decreased insulin levels and enhanced IAPP/insulin ratios in plasma, without hyperglycaemia. All BOP-treated hamsters showed pancreatic carcinogenesis at 6 months post-treatment. Supranormal plasma glucose levels in animals on a low-fat diet were the only change observed. After a second 6-month period, subnormal plasma glucose levels, at least 4-fold decreased plasma insulin and up to 2-fold decreased plasma IAPP levels were present in all hamsters. Remarkably, both in azaserine-treated rats on high-fat and in BOP-treated hamsters, decreased insulin levels and elevated IAPP/insulin ratios are not associated with hyperglycaemia. In contrast to humans with pancreatic cancer, IAPP overproduction and hyperglycaemia do not develop in rats and hamsters with (pre-)neoplastic pancreatic lesions. Int. J. Cancer 72:637-641, 1997.r 1997 Wiley-Liss, Inc.Human exocrine pancreatic cancer (EPC) usually shows ductular histology and is associated with peripheral insulin resistance and hyperglycaemia in the majority of the patients Gullo et al., 1994;Noy and Bilezikian, 1994). IAPP is a beta-cell polypeptide implicated in the pathogenesis of type-2 diabetes mellitus via the induction of insulin resistance and/or the formation of pancreatic islet amyloid (Cooper, 1994; Höppener et al., 1994;Oosterwijk et al., 1995). In the majority of patients with EPC, over-production both of insulin and of IAPP and elevated IAPP/insulin ratios in plasma were found . Tumour-derived IAPP probably does not significantly contribute to plasma IAPP levels. Although IAPP (and insulin) immunoreactivity was demonstrated in EPC samples, only minor amounts of IAPP could be extracted. Markedly decreased IAPP immunoreactivity in beta cells of tumour-surrounding islets suggested that most intracellular IAPP has been secreted, possibly due to paracrine stimulation by the tumour. It was concluded that IAPP over-production could have induced peripheral insulin resistance in patients with EPC (Pour et al., 1993;Permert et al., 1994). Tumour-induced beta-cell destruction is probably not involved in diabetes, since both the diabetes and elevated IAPP/insulin ratios in plasma disappeared after resection of the tumour Permert et al., 1994). In rats and mice, IAPP administration has been reported to induce insulin resistance and to increase plasma glucose levels (Cooper, 1994). In this respect it is suggestive that also (u...