Pancreatic cancer in type 2 diabetic patient treated with 3 oral agents including dipeptidil-peptidase-IV inhibitor

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)