Diabetes mellitus and pancreatic cancer: a literature review
AbstractDiabetes mellitus (DM) and pancreatic cancer (PC) are closely related. The long-term course of DM is considered as a moderate risk factor for the PC development. On the other hand, newly diagnosed DM is often an early symptom of PC. Meta-analyses show a 5–7-fold increased risk of PC with newly diagnosed DM, especially during the first year after diagnosis. About 50–74% of cases of PC-related diabetes develop 2–3 years before the diagnosis of PC. It has been noted that diabetes in patients with PC often undergoes remission after pancreatic resection. This indicates that there is a causal relationship between PC and newly diagnosed DM, and diabetes is an early and specific biomarker of PC, not just being its consequence.
To date, there is no unified approach to the diagnosis and treatment of diabetes in patients with PC. The review presents modern ideas about the pathogenesis, features of diagnosis and course of DM in PC, and approaches to treatment.
Keywords:diabetes mellitus; pancreatic cancer; pathogenesis; diagnosis; treatment
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Ametov A.S., Pashkova E.Yu., Antsiferova D.M., Rumer V.B. Diabetes mellitus and pancreatic cancer: a literature review. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2023; 12 (4): 55–62. DOI: https://doi.org/10.33029/2304-9529-2023-12-4-55-62 (in Russian)
References
1. Mizrahi J.D., Surana R., Valle J.W., et al. Pancreatic cancer. Lancet. 2020; 395 (10 242): 2008–20. DOI: https://doi.org/10.1016/S-0140-6736(20)30974-0
2. Toriola A.T., Stolzenberg-Solomon R., Dalidowitz L., et al. Diabetes and pancreatic cancer survival: a prospective cohort-based study. Br J Cancer. 2014; 111 (1): 181–5. DOI: https://doi.org/10.1038/BJC.2014.224
3. Petrov M.S., Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2019; 16 (3): 175–84. DOI: https://doi.org/10.1038/S 41575-018-0087-5
4. Kelly T., Yang W., Chen C.S., et al. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond). 2008; 32 (9): 1431–7. DOI: https://doi.org/10.1038/IJO.2008.102
5. Rawla P., Thandra K.C., Sunkara T. Pancreatic cancer and obesity: epidemiology, mechanism, and preventive strategies. Clin J Gastroenterol. 2019; 12 (4): 285–91. DOI: https://doi.org/10.1007/S 12328-019-00953-3
6. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014; 37 (suppl 1): S 81–90. DOI: https://doi.org/10.2337/DC-14-S081
7. Chari S.T., Leibson C.L., Rabe K.G., et al. Pancreatic cancer-associated diabetes mellitus: prevalence and temporal association with diagnosis of cancer. Gastroenterology. 2008; 134 (1): 95–101. DOI: https://doi.org/10.1053/J.GASTRO.2007.10.040
8. Sharma A., Chari S.T. Pancreatic cancer and diabetes mellitus. Curr Treat Options Gastroenterol. 2018; 16 (4): 466–78. DOI: https://doi.org/10.1007/S 11938-018-0197-8
9. Jang W.I., Kim M.S., Kang S.H., et al. Association between metformin use and mortality in patients with type 2 diabetes mellitus and localized resectable pancreatic cancer: a nationwide population-based study in Korea. Oncotarget. 2017; 8 (6): 9587–96. DOI: https://doi.org/10.18632/ONCOTARGET.14525
10. Cerullo M., Gani F., Chen S.Y., et al. Metformin use is associated with improved survival in patients undergoing resection for pancreatic cancer. J Gastrointest Surg. 2016; 20 (9): 1572–80. DOI: https://doi.org/10.1007/S11605-016-3173-4
11. Chaiteerakij R., Petersen G.M., Bamlet W.R., et al. Metformin use and survival of patients with pancreatic cancer: a cautionary lesson. J Clin Oncol. 2016; 34 (16): 1898–904. DOI: https://doi.org/10.1200/JCO.2015.63.3511
12. Kozak M.M., Anderson E.M., Von Eyben R., et al. Statin and metformin use prolongs survival in patients with resectable pancreatic cancer. Pancreas. 2016; 45 (1): 64-70. DOI: https://doi.org/10.1097/MPA.0000000000000470
13. Amin S., Boffetta P., Lucas A.L. The role of common pharmaceutical agents on the prevention and treatment of pancreatic cancer. Gut Liver. 2016; 10 (5): 665–71. DOI: https://doi.org/10.5009/GNL15451
14. Lee S.H., Yoon S.H., Lee H.S., et al. Can metformin change the prognosis of pancreatic cancer? Retrospective study for pancreatic cancer patients with pre-existing diabetes mellitus type 2. Dig Liver Dis. 2016; 48 (4): 435–40. DOI: https://doi.org/10.1016/J.DLD.2015.12.006
15. Roy A., Sahoo J., Kamalanathan S., et al. Diabetes and pancreatic cancer: exploring the two-way traffic. World J Gastroenterol. 2021; 27 (30): 4939–62. DOI: https://doi.org/10.3748/WJG.V27.I30.4939
16. Bellin M.D., Whitcomb D.C., Abberbock J., et al. Patient and disease characteristics associated with the presence of diabetes mellitus in adults with chronic pancreatitis in the United States. Am J Gastroenterol. 2017; 112 (9): 1457–65. DOI: https://doi.org/10.1038/AJG.2017.181
17. Olesen S.S., Poulsen J.L., Novovic S., et al. Multiple risk factors for diabetes mellitus in patients with chronic pancreatitis: a multicentre study of 1117 cases. United European Gastroenterol J. 2020; 8 (4): 453–61. DOI: https://doi.org/10.1177/2050640620901973
18. Pan J., Xin L., Wang D., et al. Risk factors for diabetes mellitus in chronic pancreatitis: a cohort of 2,011 patients. Medicine (Baltimore). 2016; 95 (14): e3251. DOI: https://doi.org/10.1097/MD.0000000000003251
19. Zhu X., Liu D., Wei Q., et al. New-onset diabetes mellitus after chronic pancreatitis diagnosis: a systematic review and meta-analysis. Pancreas. 2019; 48 (7): 868–75. DOI: https://doi.org/10.1097/MPA.0000000000001359
20. Kirkegard J., Mortensen F.V., Cronin-Fenton D. Chronic pancreatitis and pancreatic cancer risk: a systematic review and meta-analysis. Am J Gastroenterol. 2017; 112 (9): 1366–72. DOI: https://doi.org/10.1038/AJG.2017.218
21. Chari S.T., Mohan V., Pitchumoni C.S., et al. Risk of pancreatic carcinoma in tropical calcifying pancreatitis: an epidemiologic study. Pancreas. 1994; 9 (1): 62–6. DOI: https://doi.org/10.1097/00006676-199401000-00009
22. Pereira S.P., Oldfield L., Ney A., et al. Early detection of pancreatic cancer. Lancet Gastroenterol Hepatol. 2020; 5 (7): 698–710. DOI: https://doi.org/10.1016/S2468-1253(19)30416-9
23. Singhi A.D., Koay E.J., Chari S.T., et al. Early detection of pancreatic cancer: opportunities and challenges. Gastroenterology. 2019; 156 (7): 2024–40. DOI: https://doi.org/10.1053/J.GASTRO.2019.01.259
24. Chari S.T., Leibson C.L., Rabe K.G., et al. Probability of pancreatic cancer following diabetes: a population-based study. Gastroenterology. 2005; 129 (2): 504–11. DOI: https://doi.org/10.1016/J.GASTRO.2005.05.007
25. Dankner R., Boffetta P., Balicer R.D., et al. Time-Dependent risk of cancer after a diabetes diagnosis in a cohort of 2.3 million adults. Am J Epidemiol. 2016; 183 (12): 1098–106. DOI: https://doi.org/10.1093/AJE/KWV290
26. Batabyal P., Vander Hoorn S., Christophi C., et al. Association of diabetes mellitus and pancreatic adenocarcinoma: a meta-analysis of 88 studies. Ann Surg Oncol. 2014; 21 (7): 2453–62. DOI: https://doi.org/10.1245/S10434-014-3625-6
27. Ben Q., Xu M., Ning X., et al. Diabetes mellitus and risk of pancreatic cancer: a meta-analysis of cohort studies. Eur J Cancer. 2011; 47 (13): 1928–37. DOI: https://doi.org/10.1016/J.EJCA.2011.03.003
28. Setiawan V.W., Stram D.O., Porcel J., et al. Pancreatic cancer following incident diabetes in African Americans and Latinos: the multiethnic cohort. J Natl Cancer Inst. 2019; 111 (1): 27–33. DOI: https://doi.org/10.1093/JNCI/DJY090
29. Ben Q., Cai Q., Li Z., et al. The relationship between new-onset diabetes mellitus and pancreatic cancer risk: a case-control study. Eur J Cancer. 2011; 47 (2): 248–54. DOI: https://doi.org/10.1016/J.EJCA.2010.07.010
30. Aggarwal G., Kamada P., Chari S.T. Prevalence of diabetes mellitus in pancreatic cancer compared to common cancers. Pancreas. 2013; 42 (2): 198–201. DOI: https://doi.org/10.1097/MPA.0B013E3182592C96
31. Pannala R., Leirness J.B., Bamlet W.R., et al. Prevalence and clinical profile of pancreatic cancer-associated diabetes mellitus. Gastroenterology. 2008; 134 (4): 981–7. DOI: https://doi.org/10.1053/J.GASTRO.2008.01.039
32. Lu Y., Rodríguez L.A.G., Malgerud L., et al. New-onset type 2 diabetes, elevated HbA1c, anti-diabetic medications, and risk of pancreatic cancer. Br J Cancer. 2015; 113 (11): 1607–14. DOI: https://doi.org/10.1038/BJC.2015.353
33. Roeyen G., Jansen M., Chapelle T., et al. Diabetes mellitus and pre-diabetes are frequently undiagnosed and underreported in patients referred for pancreatic surgery. A prospective observational study. Pancreatology. 2016; 16 (4): 671–6. DOI: https://doi.org/10.1016/J.PAN.2016.04.032
34. Hart P.A., Bellin M.D., Andersen D.K., et al. Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol. 2016; 1 (3): 226–37. DOI: https://doi.org/10.1016/S2468-1253(16)30106-6
35. Pelaez-Luna M., Takahashi N., Fletcher J.G., et al. Resectability of presymptomatic pancreatic cancer and its relationship to onset of diabetes: a retrospective review of CT scans and fasting glucose values prior to diagnosis. Am J Gastroenterol. 2007; 102 (10): 2157–63. DOI: https://doi.org/10.1111/J.1572-0241.2007.01480.X
36. Permert J., Ihse I., Jorfeldt L., et al. Improved glucose metabolism after subtotal pancreatectomy for pancreatic cancer. Br J Surg. 1993; 80 (8): 1047–50. DOI: https://doi.org/10.1002/BJS.1800800841
37. Cersosimo E., Pisters P.W., Pesola G., et al. Insulin secretion and action in patients with pancreatic cancer. Cancer. 1991; 67 (2): 486–93. URL: https://pubmed.ncbi.nlm.nih.gov/1985741/ (date of access December 2, 2022).
38. Agustsson T., D’souza M.A., Nowak G., et al. Mechanisms for skeletal muscle insulin resistance in patients with pancreatic ductal adenocarcinoma. Nutrition. 2011; 27 (7–8): 796–801. DOI: https://doi.org/10.1016/J.NUT.2010.08.022
39. Liu J., Knezetic J.A., Strömmer L., et al. The intracellular mechanism of insulin resistance in pancreatic cancer patients. J Clin Endocrinol Metab. 2000; 85 (3): 1232–8. DOI: https://doi.org/10.1210/JCEM.85.3.6400
40. Wang L., Zhang B., Zheng W., et al. Exosomes derived from pancreatic cancer cells induce insulin resistance in C 2C 12 myotube cells through the PI3K/Akt/FoxO1 pathway. Sci Rep. 2017; 7 (1): 5384. DOI: https://doi.org/10.1038/S 41598-017-05541-4
41. Liao W.C., Huang B.S., Yu Y.H., et al. Galectin-3 and S 100A9: novel diabetogenic factors mediating pancreatic cancer-associated diabetes. Diabetes Care. 2019; 42 (9): 1752–9. DOI: https://doi.org/10.2337/DC19-0217
42. Sah R.P., Nagpal S.J.S., Mukhopadhyay D., et al. New insights into pancreatic cancer-induced paraneoplastic diabetes. Nat Rev Gastroenterol Hepatol. 2013; 10 (7): 423–33. DOI: https://doi.org/10.1038/NRGASTRO.2013.49
43. Sah R.P., Sharma A., Nagpal S., et al. Phases of metabolic and soft tissue changes in months preceding a diagnosis of pancreatic ductal adenocarcinoma. Gastroenterology. 2019; 156 (6): 1742–52. DOI: https://doi.org/10.1053/J.GASTRO.2019.01.039
44. Liao W.C., Chen P.R., Huang C.C., et al. Relationship between pancreatic cancer-associated diabetes and cachexia. J Cachexia Sarcopenia Muscle. 2020; 11 (4): 899–908. DOI: https://doi.org/10.1002/JCSM.12553
45. Nagpal S.J.S., Kandlakunta H., Her T., et al. Pancreatic ductal adenocarcinoma is associated with a unique endocrinopathy distinct from type 2 diabetes mellitus. Pancreatology. 2020; 20 (5): 929–35. DOI: https://doi.org/10.1016/J.PAN.2020.05.010
46. Saruc M., Iki K., Pour P.M. Morphometric studies in human pancreatic cancer argues against the etiological role of type 2 diabetes in pancreatic cancer. Histol Histopathol. 2010; 25 (4): 423–32. DOI: https://doi.org/10.14670/HH-25.423
47. Basso D., Plebani M., Fogar P., et al. Beta-cell function in pancreatic adenocarcinoma. Pancreas. 1994; 9 (3): 332–5. DOI: https://doi.org/10.1097/00006676-199405000-00008
48. Chari S.T., Zapiach M., Yadav D., et al. Beta-cell function and insulin resistance evaluated by HOMA in pancreatic cancer subjects with varying degrees of glucose intolerance. Pancreatology. 2005; 5 (2–3): 229–33. DOI: https://doi.org/10.1159/000085276
49. Mäkimattila S., Hietaniemi K., Kiviluoto T., et al. In vivo glucose-stimulated amylin secretion is increased in nondiabetic patients with pancreatic cancer. Metabolism. 2001; 50 (9): 1036–42. DOI: https://doi.org/10.1053/meta.2001.25801
50. Wang F., Larsson J., Abdiu A., et al. Dissociated secretion of islet amyloid polypeptide and insulin in serum-free culture media conditioned by human pancreatic adenocarcinoma cell lines. Int J Pancreatol. 1997; 21 (2): 157–64. DOI: https://doi.org/10.1007/BF02822387
51. Javeed N., Sagar G., Dutta S.K., et al. Pancreatic cancer-derived exosomes cause paraneoplastic β-cell dysfunction. Clin Cancer Res. 2015; 21 (7): 1722–33. DOI: https://doi.org/10.1158/1078-0432.CCR-14-2022
52. Aggarwal G., Ramachandran V., Javeed N., et al. Adrenomedullin is up-regulated in patients with pancreatic cancer and causes insulin resistance in β cells and mice. Gastroenterology. 2012; 143 (6): 1510–7. DOI: https://doi.org/10.1053/J.GASTRO.2012.08.044
53. Sagar G., Sah R.P., Javeed N., et al. Pathogenesis of pancreatic cancer exosome-induced lipolysis in adipose tissue. Gut. 2016; 65 (7): 1165–74. DOI: https://doi.org/10.1136/GUTJNL-2014-308350
54. Antolino L., Rocca M. La, Todde F., et al. Can pancreatic cancer be detected by adrenomedullin in patients with new-onset diabetes? The PaCANOD cohort study protocol. Tumori. 2018; 104 (4): 312–4. DOI: https://doi.org/10.5301/TJ.5000693
55. Bartucci R., Salvati A., Olinga P., et al. Vanin 1: its physiological function and role in diseases. Int J Mol Sci. 2019; 20 (16): 3891. DOI: https://doi.org/10.3390/IJMS20163891
56. Kang M., Qin W., Buya M., et al. VNN 1, a potential biomarker for pancreatic cancer-associated new-onset diabetes, aggravates paraneoplastic islet dysfunction by increasing oxidative stress. Cancer Lett. 2016; 373 (2): 241–50. DOI: https://doi.org/10.1016/J.CANLET.2015.12.031
57. Huang H., Dong X., Kang M.X., et al. Novel blood biomarkers of pancreatic cancer-associated diabetes mellitus identified by peripheral blood-based gene expression profiles. Am J Gastroenterol. 2010; 105 (7): 1661–9. DOI: https://doi.org/10.1038/AJG.2010.32
58. Parajuli P., Nguyen T.L., Prunier C., et al. Pancreatic cancer triggers diabetes through TGF-β-mediated selective depletion of islet β-cells. Life Sci Alliance. 2020; 3 (6): e201900573. DOI: https://doi.org/10.26508/LSA.201900573
59. Ma X., Cui Z., Du Z., et al. Transforming growth factor-β signaling, a potential mechanism associated with diabetes mellitus and pancreatic cancer? J Cell Physiol. 2020; 235 (9): 5882–92. DOI: https://doi.org/10.1002/JCP.29605
60. Tan L., Ye X., Zhou Y., et al. Macrophage migration inhibitory factor is overexpressed in pancreatic cancer tissues and impairs insulin secretion function of β-cell. J Transl Med. 2014; 12 (1): 92. DOI: https://doi.org/10.1186/1479-5876-12-92
61. Wang Y., Ni Q., Sun J., et al. Paraneoplastic β cell dedifferentiation in nondiabetic patients with pancreatic cancer. J Clin Endocrinol Metab. 2020; 105 (4): e1489–503. DOI: https://doi.org/10.1210/CLINEM/DGZ224
62. Kolb A., Rieder S., Born D., et al. Glucagon/insulin ratio as a potential biomarker for pancreatic cancer in patients with new-onset diabetes mellitus. Cancer Biol Ther. 2009; 8 (16): 1527–33. DOI: https://doi.org/10.4161/CBT.8.16.9006
63. Stern J.H., Arriaga Y., Gupta A., et al. Fasting and glucose-stimulated changes in plasma glucagon in pancreatic cancer: potential biomarkers for detection? Pancreas. 2019; 48 (1): e1–3. DOI: https://doi.org/10.1097/MPA.0000000000001208
64. Hart P.A., Baichoo E., Bi Y., et al. Pancreatic polypeptide response to a mixed meal is blunted in pancreatic head cancer associated with diabetes mellitus. Pancreatology. 2015; 15 (2): 162–6. DOI: https://doi.org/10.1016/J.PAN.2015.02.006
65. Nagpal S.J.S., Bamlet W.R., Kudva Y.C., et al. Comparison of fasting human pancreatic polypeptide levels among patients with pancreatic ductal adenocarcinoma, chronic pancreatitis, and type 2 diabetes mellitus. Pancreas. 2018; 47 (6): 738–41. DOI: https://doi.org/10.1097/MPA.0000000000001077
66. Škrha J., Bušek P., Uhrová J., et al. Lower plasma levels of glucose-dependent insulinotropic peptide (GIP) and pancreatic polypeptide (PP) in patients with ductal adenocarcinoma of the pancreas and their relation to the presence of impaired glucoregulation and weight loss. Pancreatology. 2017; 17 (1): 89–94. DOI: https://doi.org/10.1016/J.PAN.2016.12.004
67. Zhang Y., Huang S., Li P., et al. Pancreatic cancer-derived exosomes suppress the production of GIP and GLP-1 from STC-1 cells in vitro by down-regulating the PCSK1/3. Cancer Lett. 2018; 431: 190–200. DOI: https://doi.org/10.1016/J.CANLET.2018.05.027
68. Jeon C.Y., Li D., Cleary S., et al. The association of recently diagnosed diabetes and long-term diabetes with survival in pancreatic cancer patients: a pooled analysis. Pancreas. 2018; 47 (3): 314–20. DOI: https://doi.org/10.1097/MPA.0000000000000989
69. Hank T., Sandini M., Qadan M., et al. Diabetes mellitus is associated with unfavorable pathologic features, increased postoperative mortality, and worse long-term survival in resected pancreatic cancer. Pancreatology. 2020; 20 (1): 125–31. DOI: https://doi.org/10.1016/J.PAN.2019.10.007
70. Lv X., Qiao W., Leng Y., et al. Impact of diabetes mellitus on clinical outcomes of pancreatic cancer after surgical resection: a systematic review and meta-analysis. PLoS One. 2017; 12 (2): e0171370. DOI: https://doi.org/10.1371/JOURNAL.PONE.0171370
71. Bitterman D.S., Winter K.A., Hong T.S., et al. Impact of diabetes and insulin use on prognosis in patients with resected pancreatic cancer: an ancillary analysis of NRG Oncology RTOG 9704. Int J Radiat Oncol Biol Phys. 2021; 109 (1): 201–11. DOI: https://doi.org/10.1016/J.IJROBP.2020.08.042
72. Hart P.A., Law R.J., Frank R.D., et al. Impact of diabetes mellitus on clinical outcomes in patients undergoing surgical resection for pancreatic cancer: a retrospective, cohort study. Am J Gastroenterol. 2014; 109 (9): 1484–92. DOI: https://doi.org/10.1038/AJG.2014.193
73. Beg M.S., Dwivedi A.K., Ahmad S.A., et al. Impact of diabetes mellitus on the outcome of pancreatic cancer. PLoS One. 2014; 9 (5): e98511. DOI: https://doi.org/10.1371/JOURNAL.PONE.0098511
74. Raghavan S.R., Ballehaninna U.K., Chamberlain R.S. The impact of perioperative blood glucose levels on pancreatic cancer prognosis and surgical outcomes: an evidence-based review. Pancreas. 2013; 42 (8): 1210–7. DOI: https://doi.org/10.1097/MPA.0B013E3182A6DB8E
75. Fan K.Y., Dholakia A.S., Wild A.T., et al. Baseline hemoglobin-A1c impacts clinical outcomes in patients with pancreatic cancer. J Natl Compr Canc Netw. 2014; 12 (1): 50–7. DOI: https://doi.org/10.6004/JNCCN.2014.0006
76. Cheon Y.K., Koo J.K., Lee Y.S., et al. Elevated hemoglobin A1c levels are associated with worse survival in advanced pancreatic cancer patients with diabetes. Gut Liver. 2014; 8 (2): 205–14. DOI: https://doi.org/10.5009/GNL.2014.8.2.205
77. Balzano G., Dugnani E., Gandolfi A., et al. Effect of diabetes on survival after resection of pancreatic adenocarcinoma. a prospective, observational study. PLoS One. 2016; 11 (11): e0166008. DOI: https://doi.org/10.1371/JOURNAL.PONE.0166008
78. Tseng C.M., Wang H.H., Wang W.L., et al. Prognostic impact of diabetes mellitus on overall survival in a nationwide population-based cohort of patients with pancreatic cancer. Endocr Pract. 2020; 26 (7): 707–13. DOI: https://doi.org/10.4158/EP-2019-0565
79. Kleeff J., Costello E., Jackson R., et al. The impact of diabetes mellitus on survival following resection and adjuvant chemotherapy for pancreatic cancer. Br J Cancer. 2016; 115 (7): 887–94. DOI: https://doi.org/10.1038/BJC.2016.277
80. Li D., Mao Y., Chang P., et al. Impacts of new-onset and long-term diabetes on clinical outcome of pancreatic cancer. Am J Cancer Res. 2015; 5 (10): 3260–9. URL: https://pubmed.ncbi.nlm.nih.gov/26693076/ (date of access December 2, 2022).
81. Lee S., Hwang H.K., Kang C.M., et al. Adverse oncologic impact of new-onset diabetes mellitus on recurrence in resected pancreatic ductal adenocarcinoma: a comparison with long-standing and non-diabetes mellitus patients. Pancreas. 2018; 47 (7): 816–22. DOI: https://doi.org/10.1097/MPA.0000000000001099
82. Iizumi S., Kuchiba A., Okusaka T., et al. Impact of the duration of diabetes mellitus on the outcome of metastatic pancreatic cancer treated with gemcitabine: a retrospective study. Intern Med. 2019; 58 (17): 2435–41. DOI: https://doi.org/10.2169/INTERNALMEDICINE.2539-18
83. Wu J.M., Kuo T.C., Yang C.Y., et al. Resolution of diabetes after pancreaticoduodenectomy in patients with and without pancreatic ductal cell adenocarcinoma. Ann Surg Oncol. 2013; 20 (1): 242–9. DOI: https://doi.org/10.1245/S10434-012-2577-Y
84. Shingyoji A., Mikata R., Ogasawara S., et al. Diverse transitions in diabetes status during the clinical course of patients with resectable pancreatic cancer. Jpn J Clin Oncol. 2020; 50 (12): 1403–11. DOI: https://doi.org/10.1093/JJCO/HYAA136
85. Canto M.I., Kerdsirichairat T., Yeo C.J., et al. Surgical outcomes after pancreatic resection of screening-detected lesions in individuals at high risk for developing pancreatic cancer. J Gastrointest Surg. 2020; 24 (5): 1101–10. DOI: https://doi.org/10.1007/S11605-019-04230-Z
86. Singh A.N., Pal S., Kilambi R., et al. Diabetes after pancreaticoduodenectomy: can we predict it? J Surg Res. 2018; 227: 211–9. DOI: https://doi.org/10.1016/J.JSS.2018.02.010
87. Beger H.G., Poch B., Mayer B., et al. New onset of diabetes and pancreatic exocrine insufficiency after pancreaticoduodenectomy for benign and malignant tumors: a systematic review and meta-analysis of long-term results. Ann Surg. 2018; 267 (2): 259–70. DOI: https://doi.org/10.1097/SLA.0000000000002422
88. Cho J., Scragg R., Pandol S.J., et al. Antidiabetic medications and mortality risk in individuals with pancreatic cancer-related diabetes and postpancreatitis diabetes: a nationwide cohort study. Diabetes Care. 2019; 42 (9): 1675–83. DOI: https://doi.org/10.2337/DC 19-014