The Added Value of Blood Glucose Monitoring in High-Risk Individuals Undergoing Pancreatic Cancer Surveillance

Pancreas. 2024 Aug 1;53(7):e566-e572. doi: 10.1097/MPA.0000000000002335. Epub 2024 Apr 30.

Abstract

Objectives: The study aimed to investigate the added value of blood glucose monitoring in high-risk individuals (HRIs) participating in pancreatic cancer surveillance.

Materials and methods: High-risk individuals with a CDKN2A/p16 germline pathogenic variant participating in pancreatic cancer surveillance were included in this study. Multivariable logistic regression was performed to assess the relationship between new-onset diabetes (NOD) and pancreatic ductal adenocarcinoma (PDAC). To quantify the diagnostic performance of NOD as a marker for PDAC, receiver operating characteristic curve with area under the curve was computed.

Results: In total, 220 HRIs were included between 2000 and 2019. Median age was 61 (interquartile range. 53-71) years and 62.7% of participants were female. During the study period, 26 (11.8%) HRIs developed NOD, of whom 5 (19.2%) later developed PDAC. The other 23 (82.1%) PDAC cases remained NOD-free. Multivariable analysis showed no statistically significant relationship between NOD and PDAC (odds ratio, 1.21; 95% confidence interval, 0.39-3.78) and 4 of 5 PDAC cases seemed to have NOD within 3 months before diagnosis. Furthermore, NOD did not differentiate between HRIs with and without PDAC (area under the curve, 0.54; 95% confidence interval, 0.46-0.61).

Conclusions: In this study, we found no added value for longitudinal glucose monitoring in CDKN2A pathogenic variant carriers participating in an imaging-based pancreatic cancer surveillance program.

MeSH terms

  • Aged
  • Blood Glucose Self-Monitoring / methods
  • Blood Glucose* / analysis
  • Blood Glucose* / metabolism
  • Carcinoma, Pancreatic Ductal* / blood
  • Carcinoma, Pancreatic Ductal* / diagnosis
  • Cyclin-Dependent Kinase Inhibitor p16
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology
  • Early Detection of Cancer / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms* / blood
  • Pancreatic Neoplasms* / diagnosis
  • ROC Curve
  • Risk Assessment / methods
  • Risk Factors

Substances

  • Blood Glucose
  • Cyclin-Dependent Kinase Inhibitor p16
  • CDKN2A protein, human