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Higher Fasting Blood Glucose Linked with Risk of Pancreatic Cancer

For every 0.56 mmol/L increase in fasting blood glucose there was a 14% increase in the rate of pancreatic cancer…

In previous studies, an assumption has been made that diabetes may be either a risk factor or a symptom of pancreatic cancer. To investigate this connection, researchers examined both linear and non-linear dose response to determine the association between fasting blood glucose and risk of pancreatic cancer and to measure whether there is an onset for blood glucose concentration, rather than assuming linearity without validation.

Two investigators conducted this systematic review and dose-response meta-analysis of prospective observation studies. They independently searched PubMed and Scopus and reviewed the studies that demonstrated any association between blood glucose concentrations and pancreatic cancer through the end of November 2013 without language or date restriction. The authors included the meta-analysis for prospectively evaluated studies that have demonstrated an association between blood glucose and pancreatic cancer and excluded retrospective and cross sectional studies to avoid potential compounding and reverse connection.

A total of 2408 patients with pancreatic cancer were found in 9 different studies. A strong linear dose-response association between fasting blood glucose concentration and the rate of pancreatic cancer was detected from pre-diabetes patients to diabetes patients. The rate ratio of pancreatic cancer was 0.56 mmol/L, which increased to 1.14 in fasting blood glucose (95% CI 1.06 to 1.22; P<0.001). Using sensitivity analysis, blood glucose in the range of diabetes demonstrated relative results (0.56 mmol/L increase in fasting blood glucose to 1.15) (95% CI 1.05 to 1.27; P=0.003). These results demonstrated a statistically significant association between prediabetes and pancreatic cancer.

The authors reported that for every 0.56 mmol/L increase in fasting blood glucose there was a 14% increase in the rate of pancreatic cancer. The authors also stated that prediabetes is a risk factor for pancreatic cancer.

Practice Pearls:

  • There is a linear association between fasting glucose concentration and pancreatic cancer.
  • Pre-diabetic patients who are at risk of pancreatic cancer should always discuss with their physician about the prevention of pancreatic cancer.
  • Recommendation on lifestyle changes and controlling daily glucose intake is an important step.

Liao WC, Tu YK, Wu, MS, et al. Blood glucose concentration and risk of pancreatic cancer: systematic review and dose-response meta-analysis. BMJ 2014; 349:g7371