Production: Pablo Cantudo / Text: CNIO
As the biomedical sciences incorporate increasingly sophisticated methodologies and technologies, our understanding of disease improves. Diabetes is a clear example, since new classifications based on genetic and molecular characteristics are being added to the traditional classification in type 1 diabetes and type 2 diabetes that improve their diagnosis and treatment. The Genetic and Molecular Epidemiology Group, led by Núria Malats at the National Center for Oncological Research (CNIO), reveals the urgency of continuing to improve these classifications: the team publishes the results of a European case-control study in the journal Gut that shows that one of the more recently identified types of diabetes, type 3c or pancreatogenic diabetes, could also be an early manifestation of pancreatic cancer.
This tumor type has a high mortality rate – around 95% – because, due to the absence of symptoms in its early stages, it is usually diagnosed too late. Therefore, the CNIO finding would imply being able to advance in the early diagnosis of this disease, since it would allow classifying patients with type 3c diabetes as a population with a greater probability of developing pancreatic cancer.
Diabetes and pancreatic cancer are related, since this is the organ responsible for secreting insulin, which is not produced normally in diabetics: it is estimated that around 50% of patients with pancreatic cancer have diabetes. But a pending challenge for researchers is to discern which of them is the cause of the other and which is the consequence.
Until now, the most common has been to study whether diabetes could cause pancreatic cancer. “In our team we have turned the equation around and, for the first time, we have questioned whether pancreatic cancer could cause diabetes,” explains Núria Malats, lead author of the work. “Using innovative epidemiological and statistical analysis strategies, we found that pancreatic cancer is the cause of the development of type 3c diabetes in 26% of cases.”
Type 3c, or pancreatogenic, diabetes is characterized by inflammation of the pancreas that disrupts insulin production. It is estimated that it constitutes around 5-10% of all diabetes cases in Western countries, but today there are few specific markers for it, which is why it is often misdiagnosed as type 2 diabetes . It is necessary to have more precise markers that identify it correctly; Not only to be able to provide adequate treatments to patients, but because, now, the CNIO shows that their correct classification is also crucial for the early diagnosis of pancreatic cancer.
