The Dual Role of Diabetes Mellitus in Pancreatic Adenocarcinoma: A Decade of Multidisciplinary Insights from Eastern Algeria

Background: Pancreatic ductal adenocarcinoma remains difficult to treat, mostly because it is often clinically silent until advanced stages. Growing evidence points to a two-way relationship between diabetes mellitus (DM) and pancreatic cancer: DM can act as both a metabolic risk factor and an early warning sign of a paraneoplastic process. This study looks at how the timing of a DM diagnosis relates to a pancreatic cancer diagnosis in an Algerian population, highlighting this dual role.
Methods: We reviewed ten years of data (2016–2026) from two hospitals in Constantine, Algeria, including 366 patients with pancreatic cancer. We divided the patients based on when their diabetes was diagnosed compared to their cancer: long-standing DM (diagnosed 24 months or more before cancer) and new-onset diabetes (NOD; diagnosed less than 24 months before or at the same time as cancer). We then compared these groups with their tumor stages and weight changes.
Results: The average age was 67 (±9.4), with more men affected (58.2%). Diabetes was common, found in 64.8% of patients. Notably, 41.5% of the entire group had NOD. Patients with NOD were more often diagnosed at earlier, potentially operable stages (stages I–II: 24.3% vs. 11.7% for long-standing DM; p=0.021). Severe weight loss (>10% of body weight) was also closely linked to the NOD group (p<0.001).
Conclusion: Our results support the idea that diabetes, especially when it is new-onset, is both a metabolic companion and an early clinical signal of pancreatic cancer. Better collaboration between endocrinologists and oncologists could help catch these tumors earlier and improve outcomes for these high-risk patients.
Keywords: Pancreatic adenocarcinoma, diabetes mellitus, new-onset diabetes, paraneoplastic marker, retrospective study, Algeria, male predominance.

Endocrinology

1. Rahib, L., et al. (2021). Global cancer statistics 2020. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660 [Google Scholar] [Crossref]

2. Ilic, D., et al. (2021). Screening for pancreatic cancer in asymptomatic individuals. Cochrane Database of Systematic Reviews, 1(1), CD012428. [Google Scholar] [Crossref]

3. Chari, S. T., et al. (2002). New-onset diabetes: a potential clue to the early diagnosis of pancreatic cancer. Mayo Clinic Proceedings, 77(11), 1027–1032. [Google Scholar] [Crossref]

4. Everhart, J., & Wright, D. (1995). Diabetes mellitus as a risk factor for pancreatic cancer. JAMA, 273(20), 1605–1609. [Google Scholar] [Crossref]

5. Belhadj, L., et al. (2020). Pancreatic cancer in Algeria: epidemiological and clinical profile. Pancreatology, 20(3), 456-461. https://doi.org/10.1016/j.pan.2019.12.011 [Google Scholar] [Crossref]

6. Ben, Q., et al. (2015). Clinical epidemiology of pancreatic cancer in a large population-based cohort in China. Scientific Reports, 5, 11038. https://doi.org/10.1038/srep11038 [Google Scholar] [Crossref]