Sharma A, et al. - Researchers sought to investigate if, in the presence of a connection between early invasive pancreatic ductal adenocarcinomas (PDACs) with hyperglycemia, the duration of hyperglycemia would be related to the time that they have had the tumor. Data shed light on the correlation between fasting blood glucose (FBG) level with time to PDAC diagnosis and tumor volume and grade. Yielded results depicted that subjects were hyperglycemic for a mean period of 36–30 months before PDAC diagnosis. This finding could be incorporated in strategies for early detection.

Methods

• Subjects with PDACs were examined using medical databases in Olmsted County, Minnesota from 2000 through 2015 and from the Mayo Clinic’s tumor registry, from January 1, 1976 through January 1, 2017.
• A comparison was performed of the glycemic profiles of patients with PDAC (cases) vs patients without cancer, matched for age and sex (controls).
• Experts evaluated the temporal fasting blood glucose (FBG) profiles collected for 60 months before patients received a PDAC diagnosis (index date) (n=219) (cohort A), FBG profiles of patients with resected PDAC (n=526) stratified by tumor volume and grade (cohort B), and temporal FBG profiles of patients with resected PDACs from whom long-term FBG data were available (n=103) (cohort C).
• Estimation of the duration of presence of invasive PDAC before its diagnosis based on hyperglycemia, defined as significantly higher (P < .05) FBG levels in cases compared to controls served as the primary outcome.

Results

• In cohort A, no notable variation was reported in the mean FBG did not between cases and controls 36 months before the index date.
• In all cases, hyperglycemia was first noted 36-30 months before PDAC diagnosis, those with or without diabetes at baseline and those with or without resection at diagnosis.
• A rise was found in the FBG level until diagnosis of PDAC.
• In cohort B, the mean FBG did not exhibit prominent variation in controls vs cases with PDACs below 1.0 cc.
• As per the findings, the smallest tumor volume associated with hyperglycemia was 1.1-2.0 cc.
• Results displayed that the FBG level increased with tumor volume.
• Furthermore, FBG varied with tumor grade: Well- or moderately differentiated tumors (5.8 cc) produced the same FBG levels as smaller, poorly differentiated tumors (1.5 cc) (P < .001).
• In cohort C, it was discovered that the duration of pre-diagnostic hyperglycemia for cases with large-, medium-, or small-volume PDACs was 36-24, 24-12, and 12-0 months, respectively.
• Results depicted that the PDAC resection resolved hyperglycemia, irrespective of the tumor location.