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Pancreatic cancer in type 2 diabetic patient treated with 3 oral agents including dipeptidil-peptidase-IV inhibitor
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Abstract
Risk of pancreatic cancer is elevated in subjects withtype 2 diabetes. Recently also concerns regarding increasedrisk of pancreatitis and pancreatic cancer inpatients receiving incretin-based therapy has beenarisen. Early stages of the disease are usually asymptomatic.Hence, 80–85% of pancreatic cancer casesare diagnosed in an advanced stage. Painless jaundice,upper abdomen or back pain, malabsorption,cachexia, depression and thromboembolism are mostcommon clinical features of the pancreatic cancer.In this report a case of a 68 years old, slightly overweightedmale subject with a long standing type 2diabetes is described. Patient was treated with sulfonylurea,metformin and DPP-IV (dipeptidyl peptidase-IV) inhibitor, and good metabolic control of diabetes (HbA1c £ 7,0%) was maintained. During oneof the planned, consecutive visits, a significant, non-intentional 5 kg weight loss within the preceding4 months was noted. Patient was asymptomatic.However, after the diagnostic procedures, the diagnosisof pancreatic cancer was established.This case indicate the need for awareness and forthorough diagnostics of every unexpected, non-intentionalweight loss in diabetic patient. Even asymptomatic,it may be a sign of neoplastic process inthe abdomen cavity, with a special attention to pancreaticcarcinoma. (Diabet. Klin. 2012; 1, 1: 12–16)
Abstract
Risk of pancreatic cancer is elevated in subjects withtype 2 diabetes. Recently also concerns regarding increasedrisk of pancreatitis and pancreatic cancer inpatients receiving incretin-based therapy has beenarisen. Early stages of the disease are usually asymptomatic.Hence, 80–85% of pancreatic cancer casesare diagnosed in an advanced stage. Painless jaundice,upper abdomen or back pain, malabsorption,cachexia, depression and thromboembolism are mostcommon clinical features of the pancreatic cancer.In this report a case of a 68 years old, slightly overweightedmale subject with a long standing type 2diabetes is described. Patient was treated with sulfonylurea,metformin and DPP-IV (dipeptidyl peptidase-IV) inhibitor, and good metabolic control of diabetes (HbA1c £ 7,0%) was maintained. During oneof the planned, consecutive visits, a significant, non-intentional 5 kg weight loss within the preceding4 months was noted. Patient was asymptomatic.However, after the diagnostic procedures, the diagnosisof pancreatic cancer was established.This case indicate the need for awareness and forthorough diagnostics of every unexpected, non-intentionalweight loss in diabetic patient. Even asymptomatic,it may be a sign of neoplastic process inthe abdomen cavity, with a special attention to pancreaticcarcinoma. (Diabet. Klin. 2012; 1, 1: 12–16)
Keywords
pancreatic cancer; type 2 diabetes; incretin axis; glucagon-like peptide-1; DPP-IV inhibitors
About this articleTitle
Pancreatic cancer in type 2 diabetic patient treated with 3 oral agents including dipeptidil-peptidase-IV inhibitor
Journal
Issue
Article type
Research paper
Pages
12-16
Published online
2012-04-11
Page views
1259
Article views/downloads
5420
DOI
10.5603/cd.18572
Bibliographic record
Diabetologia Kliniczna 2012;1(1):12-16.
Keywords
pancreatic cancer
type 2 diabetes
incretin axis
glucagon-like peptide-1
DPP-IV inhibitors
Authors
Mariusz Dąbrowski