Diabetes--not Drugs--Is Risk Factor for Pancreatic Disease

Diabetes itself, not any specific glucose-lowering drug, is likely to blame for an increased risk of pancreatic disease, Danish researchers report.

Concerns that incretins could cause pancreatititis or pancreatic cancer are not warranted, Reimar Thomsen, MD, PhD, reported Sept. 15 at the European Association for the Study of Diabetes Meeting in Stockholm, Sweden.

In an abstract presented at the meeting, Thomas noted that incretin-based drugs (glucagon-like peptide 1 mimetics and dipeptidyl peptidase 4 inhibitors) “have been suspected to increase risk of pancreatic cancer.”

In the study, his team looked at population-based medical data and focused on 6,036 pancreatic cancer cases and 60,360 controls. The odds ratios for pancreatic cancer associated with the use of incretin based drugs and other glucose-lowering agents were calculate. The team adjusted for other pancreatic cancer risk factors.

They found that 122 incident pancreatic cancer patients (2%) had taken incretin based rugs at least once, vs. 400 controls (.7%). Further, 20.8% of cases, vs. 8.6% of controls had used any flucose-lowering agent.

The patients with pancreatic cancer more often than controls ha a history of chronic pancreatitis, gallstones, obesity, alcoholism, and chronic pulmonary disease.

The adjust risk of pancreatic cancer was increased for DPP-inhibitors (adjusted odds ratio was 3.87) and the patients who took GLP-mimetics had a heightened risk (adjusted odds ration was 2.70). But those increased risks were also seen in patients who took other glucose-lowering drugs.

“The risk of pancreatic cancer was increased to similar levels for all glucose-lowering agents,” Thomsen wrote in the abstract. “This suggests that diabetes is a risk factor for pancreatic cancer independent of a specific drug effect,” he noted, and warrants further investigation.