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September 27, 2000

Relationship Between Glucose Metabolism and Pancreatic Cancer

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(12):1512. doi:10.1001/jama.284.12.1512

To the Editor: Dr Gapstur and colleagues1 observed that higher postload plasma glucose levels were associated with an increased relative risk for pancreatic cancer in their sample of patients, most of whom were white.

While working with a predominantly Hispanic adult patient population during the last 6 years, I have come across 3 cases of hepatobiliary cancer in patients with diabetes, none of whom had a history of alcoholism or hepatitis. In recent years, there has been a reported increase in the incidence of hepatobiliary cancer, probably related to hepatitis B and C.2 One wonders if there is a similar linkage between hepatobiliary neoplasms and hyperglycemia, as there is between the latter and pancreatic malignancy. Is it possible that the insulin-activated insulin-like growth factor 1 receptor3 could have a proliferative effect on disgestive organs other than the pancreas? Because diabetes mellitus is already associated with considerable morbidity, these newfound risks would be added incentives for attaining glycemic control.

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