Association between Pancreatic Cancer and Diabetes Mellitus among Bangladeshi Patients – A Retrospective Study

Open Access

Abstract

Background: Pancreatic cancer is a highly lethal malignancy, and an increasing body of evidence suggests a complex bidirectional relationship between pancreatic cancer and diabetes mellitus (DM). Diabetes may act both as a risk factor and as an early manifestation of pancreatic cancer. However, data from South Asian populations, particularly Bangladesh, remain limited. Aim of the study: To evaluate the association between diabetes mellitus and pancreatic cancer among Bangladeshi patients and to assess the impact of diabetes-related and clinical factors on disease characteristics and stage at presentation. Methods & Materials: This retrospective observational study included 150 patients with confirmed pancreatic cancer. Patients were categorized into two groups: those with diabetes mellitus (n = 57) and those without diabetes mellitus (n = 93). Socio-demographic data, clinical characteristics, tumor features, and laboratory parameters were extracted from medical records. Diabetes-related variables included type, duration, glycemic control, and treatment. Comparative analyses were performed using appropriate statistical tests. Unadjusted odds ratios were calculated to assess risk factors, and multivariable logistic regression was conducted to identify independent predictors of advanced pancreatic cancer (Stage III–IV). Result: The mean age was significantly higher among patients with diabetes compared to those without diabetes (66.4 ± 9.1 vs. 59.2 ± 11.3 years; p < 0.001). Smoking was less prevalent in the diabetic group (33.3% vs. 46.2%; p = 0.028), while chronic pancreatitis was more frequent (12.3% vs. 4.3%; p = 0.031). Tumor location, stage distribution, metastasis at diagnosis, and CA 19-9 levels did not differ significantly between groups. Among diabetic patients, 89.5% had type 2 diabetes, and 50.9% had new-onset diabetes (<3 years). Poor glycemic control (HbA1c ≥7%) was observed in 63.2%. Multivariable analysis demonstrated that diabetes mellitus was independently associated with advanced-stage pancreatic cancer (adjusted OR 1.88; 95% CI: 1.08–3.29; p = 0.025), along with age ≥50 years, obesity, and chronic pancreatitis. Longer duration of diabetes was significantly associated with more advanced cancer stage (p = 0.039). Conclusion: Diabetes mellitus is significantly associated with advanced pancreatic cancer among Bangladeshi patients, particularly in older individuals and those with obesity or chronic pancreatitis. New-onset and longer-duration diabetes appear to be important clinical markers in pancreatic cancer. Early evaluation of pancreatic pathology in patients with diabetes may facilitate timely diagnosis and improved outcomes.