The Relationship Between Diabetes Mellitus And Pancreatic Cancer And Its Impact On The Complications Of Pancreatic Resection

Part1The relationship between diabetes mellitus and pancreatic cancerObjective:To explore the relationship between diabetes mellitus and pancreatic cancerMethods:Retrospectively reviewed medical records of case group (633patients with pancreatic cancer) and control group (240patients without pancreatic cancer). Patients in case group were divided into two subgroups (DM group and NDM grou). According to the history of DM, the patients in DM group were divided into new-onset DM group (≤2years) and not new-onset DM group. The risk of pancreatic cancer was estimated using unconditional logistic regression analysisResults:Compared with the NDM group, the DM group had higher usual body mass index(BMI).New-onset DM group had a longer length stay in hospital than both NDM group and not new-onset DM group. The not new-onset group were older and at an earlier stage of pancreatic cancer than the other two group. There were more patients taking metformin in the not new-onset group than in the new-onset DM group. New-onset group had a higher risk of pancreatic cancer, compared with NDM group (OR=5.37,95%CI:3.18～9.08, p<0.001). Although the not new-onset group also had a higher risk of pancreatic cancer than NDM, the OR is smaller(OR=1.93,95%CI:1.28～2.90,p=0.001).Conclusion:Diabetes has a high prevalence in pancreatic cancer and is frequently new onset. Diabetes is a consequence of pancreatic cancer. Among patients who meet criteria for diabetes within2years need screening of pancreatic cancer. Part2Impact of Diabetes Mellitus on perioperative outcomes after resection for pancreatic cancerObjective:To explore the impact of diabetes mellitus on periperative outcomes after resection of pancreatic cancer.Methods:Data of pancreatic cancer patients’ general information, clinical manifestations, tumor features and post-operative conditions who were admitted to the Second Affiliated Hospital of Zhejiang University from Jan.1st2008to Aug.31rd2013, was collected. Retrospective analysis of the impact diabetes mellitus has on perioperative outcomes on was done. Publically published articles on the impact diabete mellitus has on resection of pancreatic cancer on East Asian population published from1987to2013were collected, and a Meta analysis was done with STATA12.0.Results:There are no significant differences in four procedure related complications including pancreatic fistula, post-operative bleeding, delayed gastric emptying and infection and abscess between DM and NDM arm. While the prevalence of systemic complications (including heart failure, respiratory failure and renal failure) had a significant difference (p=0.022). According to meta results, in East Asian population, the correlation between diabetes mellitus and perioperative outcomes is non-significant. The occurrence of complications may has a regional and racial effect.Conclusion:In East Asian population, diabetes mellitus has no significant impact on incidence of overall postoperative complications of pancreatic cancer patients. The occurence of postoperative complications may be related to racial and geograghic factors.