New-onset Diabetes Mellitus or Diabetic Mellitus Exacerbation and Pancreatic Cancer

The relationship between new-onset Diabetes Mellitus, or rapid exacerbation of underlying Diabetes Mellitus without a known trigger, and pancreatic cancer is complicated.

Accumulating evidence shows that in stable well-controlled Diabetic patients, with rapid deterioration of Diabetes control that cannot be explained by a change in diet, weight or compliance, one should consider pancreatic imaging to exclude Pancreatic Cancer.

This also applies to patients presenting with new-onset Diabetes Mellitus.

However, there is still no consensus or definitive guidelines regarding this issue.

I aim to investigate this issue and examine the need for new guidelines regarding this topic.

In this case, I describe a 55-year-old female patient with Morbid Obesity, an underlying Psychiatric condition, and Type 2 Diabetes Mellitus, which had previously been well controlled, who presented at our clinic with a rapid deterioration of her Diabetes control.

We assumed that the deterioration of her Diabetes control was related to her diet and her underlying psychiatric disease.

Three months later she presented with Sepsis and during the inpatient investigation, she was diagnosed with Metastatic Pancreatic Cancer and from which she died a week later.

Conclusions:
My conclusion is that there is a need to consider adding additional imaging guidelines regarding the new onset of Diabetes Mellitus or an unexplained deterioration of underlying Diabetes Mellitus, about a possible underlying diagnosis of Pancreatic Cancer. There are a few questions that need to be addressed regarding this topic: When to suspect and when to perform abdominal imaging, Is it helpful or useful to do abdominal imaging or is it redundant because it will not change the disease progression