Dear Doctors: I just learned I have prediabetes. I also learned that a lot of people with pancreatic cancer have trouble with blood sugar control. A connection between prediabetes and pancreatic cancer is really scary, and I would like to know more.
Dear Reader: While cancer of the pancreas is the 10th most common cancer, it is the third most common cause of cancer deaths. This is because noticeable symptoms of this cancer often appear only once the disease is quite advanced, when it has spread to other areas of the body.
Diabetes, by contrast, has become so common and widespread that it is considered to be a national epidemic. It is estimated that at least 40 million people over the age of 18 are living with diabetes in the United States. That’s close to 15% of adults.
Another 100 million people in the U.S. share your diagnosis of prediabetes. Also known as impaired glucose tolerance, it is a condition in which chronically elevated blood sugar levels are approaching the diabetes benchmark. All of this makes the possible correlation between poor blood glucose and pancreatic cancer that you are asking about quite concerning.
The pancreas is a spongy, glandular organ about 6 to 8 inches long. Shaped like a sideways comma, it sits deep within the abdomen, surrounded by the liver, stomach, small intestine and spleen. The two main jobs of the pancreas are to aid in digestion and help with blood sugar regulation. It does the latter by producing insulin, the hormone essential to moving glucose from the blood into the cells. It is here that a possible link between diabetes and pancreatic cancer comes into play. When blood sugar levels rise, the beta cells of the pancreas send out insulin. If blood sugar is chronically high, as in diabetes, the pancreas is forced into overdrive.
The data show that up to 80% of people who are diagnosed with pancreatic cancer have either recently developed Type 2 diabetes or have prediabetes. There is also evidence that long-term diabetes is a risk factor for this type of cancer. Whether or not this indicates a direct connection between the two diseases is not yet clear. One idea that is being explored is that a new diagnosis of diabetes, also known as new-onset diabetes, may be a symptom of pancreatic cancer. Another potential explanation is that the presence of the cancer itself may have an adverse effect on mechanisms involved in blood glucose control.
Even without a direct connection to pancreatic cancer, the chronically high blood sugar you have been diagnosed with should be addressed. Data collected by the American Diabetes Association show that 70% of people living with prediabetes eventually go on to develop Type 2 diabetes. Chronic prediabetes is also associated with early forms of kidney disease, damage to the retina, neuropathy and an increased risk of certain types of vascular disease. The good news is that with proper diet, regular exercise and reaching a healthful weight, prediabetes can be reversed. Please be sure to follow the treatment plan that your doctor has provided.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
