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Diabetes, Weight Loss and Pancreatic Cancer

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For many people with diabetes, weight loss is a good thing. But when the weight loss is unintentional, not so much. A new study published in the medical journal JAMA Oncology indicates that people with newly developed diabetes who also experience weight loss are at a high risk for pancreatic cancer.

The study examined the health records of 159,025 people collected over a 30-year period. About 70% (112,818) were women who took part in the Nurses’ Health Study (NHS), a massive investigation into the risk factors for major chronic diseases in women that started in 1976. The male 30% (46,207) were drawn from the Health Professionals’ Follow-Up Study, a similarly large investigation of men’s health launched in 1986 to complement the all-female NHS. The average ages of the women was about 60 and of the men 65. The researchers excluded any subjects who had either diabetes or cancer at the baseline start (the year 1978 for the women, 1988 for the men).

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During the study period the researchers identified 1,116 cases of pancreatic cancer among all the subjects. They then determined that people with recent-onset diabetes (a diagnosis within four years) who lost 1 to 8 pounds had more than triple the risk of pancreatic cancer compared to those without either diabetes or weight loss. If the subjects lost more than 8 pounds, the risk of pancreatic cancer was seven times as great.

The findings were not especially surprising because it’s already been established that recent-onset diabetes is associated with a higher risk of pancreatic cancer. Similarly, researchers have already recognized that unintentional weight loss is also associated with pancreatic cancer. Unintentional weight loss is associated with other cancers, too, as well as with a long list of health problems, including celiac disease, Crohn’s disease, HIV/AIDS, tuberculosis, heart failure, dementia, Parkinson’s disease and depression.

The researchers’ new report confirmed the earlier findings that new-onset diabetes is associated with pancreatic cancer and weight loss is, too, but what’s new about their findings is that the combination of the two seems especially dangerous. As Peter Campbell, PhD, of the American Cancer Society told the online medical news service MedPage Today, “The more novel finding here is that when both risk factors are combined, the risk is even greater.” The relevance of the new study, therefore, has to do with pancreatic cancer screening. Pancreatic cancer is one of the deadlier forms of the disease. Although it can be cured with aggressive treatment if discovered early, about eight out of ten people who receive a diagnosis already have an advanced, incurable case. Now that researchers understand that the combination of new-onset diabetes and unintended weight loss is especially hazardous, physicians will need to be aware that certain of their patients might warrant pancreatic cancer screening.

Screening every adult for pancreatic cancer isn’t recommended, but it would help if specialists could identify high-risk patients. As Dr. Campbell put it, “While this finding isn’t surprising, it underscores the importance of clinicians being aware of the relevance of these two risk factors in combination. In the future it’ll be important to see if this combined risk factor would be useful to determine whether some patients might be appropriate candidates for additional follow-up work for a pancreatic cancer diagnosis.” As the study authors explained about their findings, “The identified risks in this population were similar to those for families with a history of pancreatic cancer and inherited genetic mutations in pancreatic cancer predisposition genes. Members of such families undergo pancreatic cancer surveillance after age 50 to 55 at specialized clinics and data indicate a shift to earlier-stage diagnosis and longer patient survival with surveillance.”

Want to learn more about newly diagnosed diabetes? Read “Living With Type 1 Diabetes: Four Tips to Get You Started” and “Welcome to Diabetes.”



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