As biomedical science includes increasingly complex methodologies and techniques, understanding of diseases improves. Diabetes is a clear example, as new classifications are added to the traditional designation for type 1 and type 2 diabetes; These new classifications rely on genetic and molecular properties that improve diagnosis and treatment.
The Genetic and Molecular Epidemiology Group, led by Nuria Malatez at the Spanish National Center for Cancer Research (CNIO), shows the need to further improve these classifications: In the journal Gut, the team published the results of a European case-control study showing that one of the newly identified types of diabetes, Type 3C or pancreatic diabetes, can also be an early manifestation of pancreatic cancer.
This type of cancer has a high mortality rate - about 95% - because it has no symptoms at an early stage, and it is usually diagnosed late. Therefore, the discovery of CNIO means that early diagnosis of this disease is possible because it allows the classification of patients with type 3c diabetes as a population group with an increased risk of developing pancreatic cancer at an early stage.
Disguised symptoms
Diabetes and pancreatic cancer are linked because the pancreas secretes insulin. In diabetics, this does not happen naturally. It is estimated that about 50% of pancreatic cancer patients suffer from diabetes. But it is difficult for researchers to know the cause and effect.
To date, the most common approach has been to examine whether diabetes can cause pancreatic cancer. "Our team has overturned the equation, and for the first time, we asked if pancreatic cancer could cause diabetes," explains Nuria Malatez, the lead author of the paper. "Using innovative strategies for epidemiological and statistical analysis, we found that pancreatic cancer is the cause of the development of type 3C diabetes in 26% of cases."
Type 3C diabetes, or pancreas, is characterized by pancreatitis that stops insulin production. It is estimated that they account for about 5 to 10% of all cases of diabetes in western countries. Still, currently, there are a few specific markers of this that are misdiagnosed as type 2 diabetes. More accurate signs are needed to define them as Correct, not only to provide the right treatment for patients but also because CNIO now shows that the correct classification is crucial for early diagnosis of pancreatic cancer.
To conduct the study, the team used data from more than 3,500 people from PanGenEU, a large European study that includes centers from six countries, including Spain, led by Malats, to analyze the relationship between multiple risk factors and pancreatic cancer.
To be able to address pancreatic cancer in the early stages, groups at risk must be identified first so that they can be monitored for tumor detection and disposal in its early stages. "Using information from our study, national health systems can identify patients with undetected pancreatic cancer yet, if patients, in addition to type 3C diabetes, also have certain risk factors associated with pancreatic cancer, such as obesity or a smoker says," all of these will help Factors Family doctors choose which patients better can benefit from more active observation or enter examination programs. Our discovery can be moved to national health systems as a factor to consider for early detection of pancreatic cancer. "
The researchers wanted to test whether type 2 diabetes could also be associated with this cancer, but in this case, the study was unable to determine a clear causal relationship. "We have seen that the relationship between pancreatic cancer and type 2 diabetes is very complex, as obesity plays a role as well. More studies are needed to understand how to reach the metabolic state in which all these phenomena appear."
More information: Deciphering the complex interaction between pancreatic cancer, subtypes of diabetes, and obesity / BMI through causal inference and mediation analyzes. Esther Molina-Montes et al. (Gut, 2020). Doi: 10.1136 / gutjnl-2019-319990
Quote: The study confirms type 3C diabetes as an early manifestation of pancreatic cancer (2020, May 13) retrieved on May 13, 2020, from https://medicalxpress.com/news/2020-05-diabetes-3c-early-manifestation-pancreatic .html
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