Increased Insulin Associated With a Higher Risk of Pancreatic Cancer

High insulin levels, which are frequently seen in individuals with obesity and type 2 diabetes, have been directly linked to pancreatic cancer.

The University of British Columbia's Faculty of Medicine research team offers the first thorough justification for the higher risk of pancreatic cancer in those with type 2 diabetes and obesity.

The study, published in Cell Metabolism, says the pancreatic acinar cells, which generate digestive juices, are overstimulated by high insulin levels. These cells become precancerous cells due to inflammation brought on by this overstimulation.

"Alongside the rapid increase in both obesity and Type 2 diabetes, we’re seeing an alarming rise in pancreatic cancer rates. These findings help us understand how this is happening, and highlights the importance of keeping insulin levels within a healthy range, which can be accomplished with diet, exercise and in some cases medications."

- James Johnson, co-senior author

The most common kind of pancreatic cancer, pancreatic ductal adenocarcinoma (PDAC), was the subject of the study. PDAC is an extremely aggressive malignancy with a five-year survival rate of fewer than 10%. The disease is predicted to overtake all other cancer-related causes of death by 2030.

According to the study's first author Anni Zhang, their research indicates that insulin receptors in acinar cells have a direct role in the onset of pancreatic cancer when hyperinsulinemia is present. The process entails elevated pancreatic inflammation brought on by increased synthesis of digesting enzymes.

Although its function in controlling blood sugar levels is well known, this work highlights the significance of insulin in pancreatic acinar cells.

Insulin and pancreatic cancer

The results demonstrate that although insulin's enhanced activity at high levels might unintentionally promote pancreatic inflammation and the growth of precancerous cells, it also promotes these cells' natural role of creating digestive enzymes that aid in the breakdown of fat-rich diets.

The discoveries could open the door to fresh methods for preventing cancer and perhaps for treating it by focusing on the insulin receptors in acinar cells.

Working with experts from the Pancreas Centre BC and BC Cancer, the team has started a clinical trial to assist patients with PDAC in managing their blood sugar and insulin levels through the use of an endocrinologist.

The results, according to the researchers, may have consequences for other malignancies linked to obesity and type 2 diabetes, where high insulin levels may also be a factor in the development of the illness.

Johnson concludes that colleagues in Toronto have demonstrated comparable links between insulin and breast cancer, and the team intends to investigate if and how high insulin may be linked to additional malignancies caused by diabetes and obesity in the future.