Abstract
In a total of 110 patients (67 male and 43 female) with pancreatic cancer; the ratios of associated diabetes mellitus, questionable diabetes and non-diabetic cases were 21.8, 29.1 and 49.1%, respectively on admission, and 37.3, 29.1 and 33.6%, respectively in the later stage. Primary diabetes which definitely preceded pancreatic cancer was thought to be found in 5.5% of the above cases.
Pancreatic diabetes occurred more often in cancer of the head of the pancreas than the body and tail. Furthermore, an elevation of serum and urinary amylase levels, dilatation of the main pancreatic duct, pancreatic atrophy and pancreatic fibrosis were also more often found in cancer of the head of the pancreas than that of the body and tail. These results strongly support the theory that diabetes mellitus following pancreatic cancer comes from associated obstructive pancreatitis rather than from the pancreatic cancer itself.
Incidence of diabetes increased among those who had an operation (pancreatectomy), radiotherapy and intravenous hyperalimentation. Food intake was low and unstable in most cases and insulin therapy was performed in 24.5% of the 110 cases. Diabetic microangiopathies were less but malnutrition was often recognized, in comparison with primary diabetes. From these observations, it is very important to keep blood glucose under excellent control by giving an appropriate dose of insulin matched with sufficient supply of calory.
