New-onset diabetes in pancreatic cancer: a study in the primary care setting.
New-onset diabetes in pancreatic cancer: a study in the primary care setting.
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DOI：
10.1016/j.pan.2012.02.003
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发表时间：
2012-03
期刊：
影响因子：
--
通讯作者：
Chari ST
中科院分区：
文献类型：
--
作者：
Aggarwal G;Rabe KG;Petersen GM;Chari ST
糖尿病（DM）的发病通常首先由初级保健医生注意到。新发糖尿病（PaC诊断前病程<36个月）可能是胰腺癌（PaC）的先兆。然而，其临床意义尚不清楚。为了确定初级保健环境中PaC患者DM的患病率、发病率和诊断延迟，我们回顾性分析了1995年至2009年在马约诊所初级保健诊所随访的最终诊断为PaC的连续患者的记录（前2年至少一次访视）。糖尿病的发病日期为空腹血糖≥126 mg/dl的第一天。在111例PaC患者（59例男性，中位年龄74岁）中，52例（47%）患有DM，其中30例（58%）为新发DM。在30例新发DM患者中，24例（80%）在DM发作时无症状（无癌症特异性症状）。在这24例患者中，PaC诊断前DM的中位持续时间为6.5（0.5e35）个月，从发病到医生诊断为DM的中位延迟时间为2.5（0.25-14）个月，从8.8个月下降到1995年至1999年期间发病的DM患者为3.5-14个月，2004年至2009年期间发病的DM患者为0（0-2）个月。然而，未确诊的DM患者比例（约33%）保持不变。糖尿病在PaC中非常常见（约50%）。在超过五分之一的PaC中，DM的发作发生在癌症无症状时，这为诊断早期PaC提供了潜在的机会窗口。然而，近三分之一的PaC新发DM仍未确诊。
Onset of diabetes mellitus (DM) is often first noted by primary care physicians. New-onset DM (duration <36 months before PaC diagnosis) can be a harbinger of pancreatic cancer (PaC). However, its clinical significance remains unclear. To determine the prevalence, onset, and delay in diagnosis of DM in PaC patients in the primary care setting, we retrospectively reviewed the records of consecutive patients followed in Mayo Clinic's primary care clinics (at least one visit in the preceding 2 years) from 1995 to 2009 who were eventually diagnosed with PaC. Onset of DM was the first date the fasting blood glucose was ≥126 mg/dl. Of the 111 PaC patients (59 male, median age 74 years), 52 (47%) had DM of whom 30 (58%) had new-onset DM. Among the 30 with new-onset DM, 24 (80%) were asymptomatic (no cancer-specific symptoms), at DM onset. In these 24 patients, median duration of DM prior to PaC diagnosis was 6.5 (0.5e35) months, and median delay between onset and physician diagnosis of DM was 2.5 (0.25–14) months, which decreased from 8.8 (3.5–14) months in patients with DM onset between 1995 and 1999 to 0 (0–2) months, in patients with DM onset between 2004 and 2009. However, the proportion of patients with undiagnosed DM (~33%) remained unchanged. Diabetes is very common (~50%) in PaC. In over a fifth of PaC, the onset of DM occurs when the cancer is asymptomatic, providing a potential window-of-opportunity to diagnose early PaC. However, nearly a third of new-onset DM in PaC remains undiagnosed.
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影响因子：
7.2
作者：
Damiano, J;Bordier, L;Bauduceau, B
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