PMID- 33453685
OWN - NLM
STAT- MEDLINE
DCOM- 20210915
LR  - 20210915
IS  - 1095-8673 (Electronic)
IS  - 0022-4804 (Linking)
VI  - 261
DP  - 2021 May
TI  - Pancreatic Cancer-Associated Diabetes is Clinically Distinguishable From 
      Conventional Diabetes.
PG  - 215-225
LID - S0022-4804(20)30876-3 [pii]
LID - 10.1016/j.jss.2020.12.015 [doi]
AB  - BACKGROUND: Type 3c diabetes mellitus (T3cDM) is diabetes secondary to other 
      pancreatic diseases such as chronic pancreatitis, pancreatic resection, cystic 
      fibrosis, and pancreatic ductal adenocarcinoma (PDA). Clinically, it may easily 
      be confused with conventional type 2 diabetes mellitus (T2DM). A delay in 
      pancreatic cancer diagnosis and treatment leads to a worse outcome. Therefore, 
      early recognition of PDA-associated T3cDM and distinction from conventional T2DM 
      represents an opportunity improve survival in patients with PDA. METHODS: Six 
      hundred and sixty four patients with PDA underwent pancreatic resection. Patients 
      were classified as per whether or not they had diabetes. The specific type of 
      diabetes was determined. T3cDM surgical patients (n = 127) were compared with a 
      control group of medical patients with T2DM who did not have PDA (n = 127). 
      RESULTS: Patients with T3cDM were older (66 versus 61 y, P < 0.001), had lower 
      body mass indices (25.9 versus 32.1, P < 0.001), more favorable hemoglobin A1c 
      levels (7.0 versus 8.8, P < 0.001), higher alanine aminotransferase levels (39 
      versus 20, P < 0.001), and lower creatinine levels (0.8 versus 0.9 mg/dL, 
      P < 0.001). In addition, they were more likely to be insulin dependent. In a 
      subgroup analysis of surgical patients, T3cDM (versus surgical patients with T2DM 
      and no diabetes) was not associated with surrogate markers of main pancreatic 
      duct obstruction and glandular atrophy. CONCLUSIONS: PDA-associated T3cDM has a 
      distinctive presenting phenotype compared with medical patients with conventional 
      T2DM. Greater attention to associated signs, symptoms, and biochemical data could 
      identify patients at risk for harboring an underlying pancreatic malignancy and 
      trigger diagnostic pathways leading to earlier PDA diagnosis and treatment.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Yoon, Bo Hyung
AU  - Yoon BH
AD  - Department of Internal Medicine, Thomas Jefferson University Hospital, 
      Philadelphia, Pennsylvania.
FAU - Ang, Su Mae
AU  - Ang SM
AD  - Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, 
      Pennsylvania.
FAU - Alabd, Andre
AU  - Alabd A
AD  - Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, 
      Pennsylvania.
FAU - Furlong, Kevin
AU  - Furlong K
AD  - Department of Endocrinology, Thomas Jefferson University Hospital, Philadelphia, 
      Pennsylvania.
FAU - Yeo, Charles J
AU  - Yeo CJ
AD  - Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, 
      Pennsylvania.
FAU - Lavu, Harish
AU  - Lavu H
AD  - Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, 
      Pennsylvania.
FAU - Winter, Jordan M
AU  - Winter JM
AD  - Department of Surgery, UH Cleveland Medical Center, Cleveland, Ohio. Electronic 
      address: jordan.winter@UHHospitals.org.
LA  - eng
PT  - Journal Article
DEP - 20210113
PL  - United States
TA  - J Surg Res
JT  - The Journal of surgical research
JID - 0376340
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Blood Glucose
MH  - Carcinoma, Pancreatic Ductal/*complications/diagnosis
MH  - Diabetes Mellitus/blood/diagnosis/*etiology
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pancreatic Neoplasms/*complications/diagnosis
MH  - Retrospective Studies
MH  - Young Adult
OTO - NOTNLM
OT  - Pancreatic cancer
OT  - Type 3c diabetes mellitus
EDAT- 2021/01/17 06:00
MHDA- 2021/09/16 06:00
CRDT- 2021/01/16 20:16
PHST- 2020/02/21 00:00 [received]
PHST- 2020/11/11 00:00 [revised]
PHST- 2020/12/07 00:00 [accepted]
PHST- 2021/01/17 06:00 [pubmed]
PHST- 2021/09/16 06:00 [medline]
PHST- 2021/01/16 20:16 [entrez]
AID - S0022-4804(20)30876-3 [pii]
AID - 10.1016/j.jss.2020.12.015 [doi]
PST - ppublish
SO  - J Surg Res. 2021 May;261:215-225. doi: 10.1016/j.jss.2020.12.015. Epub 2021 Jan 
      13.