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Tuesday, 31 January 2017
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Diabetes could be a warning sign of pancreatic cancer
"Experts have revealed the onset of diabetes, or existing diabetes getting much worse could be a sign of hidden pancreatic cancer," reports The Daily Express.
The media reports follow a press release of a study presented at the European Cancer Congress (ECCO) yesterday. The research analysed nearly a million people with type 2 diabetes in Belgium and Italy, some of whom went on to be diagnosed with pancreatic cancer.
The recent onset of diabetes appeared to be a possible warning sign of pancreatic cancer, with 25% of cases in Belgium and 18% in Italy being diagnosed within three months of a diabetes diagnosis. Faster progression of diabetes (where patients needed insulin or other more intensive treatments sooner) was also associated with a greater chance of being diagnosed with pancreatic cancer.
Pancreatic cancer is rare and often has a poor outcome, partly because it is difficult to detect at an early stage.
However, it's important to put these findings in context. Diabetes has previously been linked with pancreatic cancer, though it is unclear why. It could be that diabetes increases the risk of pancreatic cancer. What is probably more likely is that rapid onset or progression of diabetes could be a symptom of the cancer itself.
Diabetes is fairly common in the UK, with around 4 million cases, while pancreatic cancer remains very rare. Just because you have diabetes does not mean you will go on to get pancreatic cancer.
However, if you are concerned that you may have diabetes or that your diabetes is poorly controlled, you should talk to your GP.
There are also steps you can take to reduce your risk of developing diabetes.
Where did the story come from?
The study was carried out by researchers from the International Prevention Research Institute in Lyon, France. The study has not yet been published in a journal but was presented at the European Cancer Congress held in Amsterdam. The findings come from the press release.
Funding was provided by Sanofi, a French pharmaceutical company. The authors declare the sponsor had no influence on the study design, conduct, analysis and reporting.
This has been reported widely in the UK media, though not always accurately. The Mail Online claims the researchers "analysed nearly a million type 2 diabetics in Italy and Belgium who had been told they had pancreatic cancer" however this was the number of people in the database with diabetes. Only 2,757 people had been diagnosed with pancreatic cancer.
Moreover, The Daily Telegraph reports "50 per cent of patients diagnosed with pancreatic cancer had been diagnosed with type 2 diabetes the previous year". This is rather misleading and suggests 50% of all people with pancreatic cancer also have diabetes.
But this study only looked at people with diabetes. Of those who developed pancreatic cancer, half had received their diabetes diagnosis in the past year. The overall proportion of all people with pancreatic cancer who also have diabetes in the population is unknown.
What kind of research was this?
This was a retrospective cohort study looking at the association between type 2 diabetes and the diagnosis of pancreatic cancer.
The study is currently only available as a published abstract and was presented at the European Cancer Congress with an accompanying press release. A full study publication is not available so we can't fully critique the methods and analysis.
Pancreatic cancer has a notoriously poor prognosis as it is often hard to diagnose at an early stage due to a lack of symptoms or non-specific symptoms. Individual outcomes vary, but generally only 1% of all people diagnosed with pancreatic cancer live for more than 10 years after their diagnosis.
Diabetes has already been linked as a possible risk factor for pancreatic cancer, but in what context is uncertain. However, onset of diabetes or rapid deterioration of current diabetes could be a possible marker for early pancreatic cancer so could potentially aid earlier diagnosis.
What did the research involve?
The researchers used a prescription database (the Inter Mutualist Agency AIM-IMA) to identify 368,377 people receiving treatment for type 2 diabetes patients in Belgium between 2008 and 2013. They also identified 456,311 being treated in Lombardy, Italy, between 2008 and 2012.
These data were linked to pancreatic cancer data from the Belgium Cancer Registry and hospital discharge databases in Lombardy.
The rates of pancreatic cancer were analysed in association with time of first prescription of diabetes drugs, and use of different diabetes treatments.
What were the basic results?
In Belgium, 885 of 368,377 people with diabetes had pancreatic cancer. In Lombardy, 1,872 of 456,311 people with diabetes had pancreatic cancer.
Among all those with pancreatic cancer in the two regions, 50% had been diagnosed within one year of being diagnosed with type 2 diabetes.
In Belgium, 25% of pancreatic cancer cases were diagnosed within 90 days and in Lombardy 18% were diagnosed within 90 days.
When considering treatment, the researchers generally found that switching to more intensive diabetes treatments was also linked with a greater risk of pancreatic cancer diagnosis:
- People who switched from oral diabetes drugs to more intensive treatment of incretin-based therapy (injected drugs that help the body produce more insulin) had 3.3 times the risk (95% confidence interval [CI] 2.0 to 5.5) of cancer diagnosis in the following three months.
- This decreased to around a two-fold risk for 3 to 6 months after the first prescription of incretin drugs (hazard ratio [HR] 2.3, 95% CI 1.2 to 4.7) and again for 6 to 12 months after the first prescription (HR 2.1, 95% CI 1.2 to 3.9).
- Switch from oral diabetes drugs or incretin to insulin injections was also linked with increased risk of pancreatic cancer (HR 11.9, 95% CI 10.4 to 13.6).
- When comparing those who developed pancreatic cancer with those who remained cancer-free, switching from oral diabetes drugs to incretin or insulin injections happened sooner after diabetes diagnosis in those who developed cancer: median 372 days to switch to incretins and 315 days to switch to insulin in those who developed cancer versus median 594 days to switch to incretins and 437 days to switch to insulin.
How did the researchers interpret the results?
The lead researcher commented: "There is currently no good, non-invasive method for detecting pancreatic cancer that is not yet showing any visible signs or symptoms. We hope that our results will encourage the search for blood markers indicating the presence of pancreatic cancer, which could guide decisions to perform a confirmation examination like endoscopy."
Conclusion
This study uses a large prescription database to investigate the link between diabetes and pancreatic cancer, looking at the timing of first diabetes prescription and change in drugs prescribed.
Among people with type 2 diabetes, diagnosis of pancreatic cancer was linked with recent onset of diabetes or rapidly deteriorating diabetes. This suggests these could both be potential warning signs of hidden pancreatic cancer and indicate the need for more investigations.
While diabetes has previously been linked with pancreatic cancer, the nature of the cause and effect relationship remains unclear. It could be that diabetes increases risk of the cancer, or it could be that recent onset or deterioration of diabetes is a symptom of the cancer.
It had also previously been thought that incretin therapies could promote pancreatic cancer. However, it could be that incretin therapies and insulin therapies are often prescribed sooner in patients who have undiagnosed pancreatic cancer.
As the authors make clear, it is probably pancreatic cancer that causes deterioration of diabetes.
A limitation of this study is that it was carried out in two specific areas in Europe. Sociodemographic variations in diabetes or cancer prevalence, medical care or risk factors may mean the results are not fully applicable to the UK.
The findings are also based on a prescription database, so only look at raw data on numbers. The researchers haven't delved further into the nature of the individual diabetes and cancer diagnoses, investigations and treatment.
These are early findings presented at a conference. A full, published study is not available so it is not possible to analyse the methods and possible implications further.
It's not possible to say whether the findings could lead to more in-depth investigation of people with newly diagnosed or rapidly progressing diabetes, or whether this could make earlier pancreatic cancer diagnosis and improved survival rates possible.
Links To The Headlines
Pancreatic cancer symptoms: Diabetes could be a warning sign for deadly disease. The Daily Express, January 30 2017
Having diabetes is a warning sign of one of the deadliest forms of CANCER, shocking study finds. Mail Online, January 30 2017
Diabetes could be a warning sign of cancer, new study suggests. The Daily Telegraph, January 30 2017
Breast pumps flummox airport staff - your stories
Exercise May Help Black Americans Lower Blood Pressure Risk
Recommended 150 minutes of moderate activity weekly cut odds by almost 25 percent in study
Source: HealthDay via Exercise and Physical Fitness New Links: MedlinePlus RSS Feed Read More Here..
Doctors make plea to PM over NHS funding
Call off the breakfast wars and pass another slice of toast
Malaria treatment used in UK failed for the first time
Drug resistance ‘biggest threat’ to beating malaria Related items from OnMedica Malaria prophylaxis UK sets up £1bn fund to fight malaria Anti-malaria drug could help fight tumours World ‘not prepared’ for Zika and Ebola Study quantifies human consequences of increased antibiotic resistance |
GPs should routinely ask elderly about falls, says NICE
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HIV infection may make patients vulnerable to diabetes
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Monday, 30 January 2017
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Sledding, climbing stairs -- even house-cleaning -- are great pursuits that burn calories, dietary experts say
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Ways to Stay Active in Winter
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Diabetes can be warning sign for pancreatic cancer
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Friday, 27 January 2017
Healthier Copycat Recipes to Serve Up at Your Super Bowl Party
Unless my team is playing, the Super Bowl is all about the food. I want to be able to eat and serve foods that my friends will love, but are still healthier than your typical store-bought or takeout options, which can be sky-high in calories and sodium. Cooking at home means I get to control the ingredients and sneak in vegetables when possible. Everyone still gets to enjoy classic game-day eats, like guacamole, wings, chili, pizza and dip. Plus, if someone's eating gluten-free, vegan, Paleo or Whole30 style—they can still enjoy some of the spread.
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On The Pulse - January 2017
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Boost Confidence with Brain Training
Confidence is an attractive and necessary quality to succeed in business, relationships, and life. But, it is a subjective and, sometimes, misunderstood characteristic. From the painfully shy to the arrogantly over-confident, what makes people think and feel what they think and feel about themselves? The authors of a new study report that they have uncovered brain activity patterns that are associated with confidence. And, what’s more, they say that people can be trained to have more confidence.
The new study, published in Nature Communications, used imaging techniques and a method of neural activation called decoded neurofeedback to analyze the brain activity patterns of 17 young-adult participants. The participants engaged in simple perceptual and behavioral exercises that allowed the team of researchers to identify low-confidence and high-confidence brain activity patterns. Next, the participants were given a small monetary reward every time the researchers detected a high-confidence state. The participants also rated their own levels of confidence after the tasks. In the end, the participants unconsciously raised their levels of confidence, in real time, even though they were unaware of the manipulation.
Self-confidence is generally a belief in one’s own abilities. It is a complex internal, emotional state—influenced by myriad factors—that describes how we feel about ourselves. A lack of self-confidence can lead to shyness, social anxiety, lack of assertiveness, communication difficulties, and mental health problems. These factors can, in turn, negatively impact activity levels, relationships, and careers.
To date, self-confidence has been primarily assessed through introspection and self-reports. However, recently, the deeply subjective nature of self-confidence has been examined as an objective quality. Through functional imaging techniques, scientists are beginning to develop neural models for the feelings of confidence, and these new findings have important implications for psychiatry and psychology, as well as understandings of behavior and decision-making.
Self-confidence does not look or feel the same for all people, and, regardless of objective measures of brain activity, it will continue to be an individualized phenomenon, for the most part. The new study does not leave readers with any self-help steps that can be used to improve self-confidence outside of a laboratory setting, but it does support the perspective that self-confidence is flexible and fluid. The finding that self-confidence can be changed by training one’s brain may bring the scientific world one step closer to understanding just how and why certain mental states exist—and, what can be done to change them.
References
Cortese A, Amano K, Koizumi, A, et al. Multivoxel neurofeedback selectively modulates confidence without changing perceptual performance. Nat Commun. 2016;7:13669. PMID: 27976739.
Fleming SM, Maniscalco B, Ko Y, et al. Action-specific disruption of perceptual confidence. Psychol Sci. 26(1):89-98. PMID: 25425059.
Kepecs A, Mainen ZF. A computational framework for the study of confidence in humans and animals. Philos Trans R Soc Lond B Biol Soc. 2012;367(1594):1322-1337. PMID: 22492750.
Kepecs A, Mensh BD. Emotor control: computations underlying bodily resource allocation, emotions, and confidence. Dialogues Clin Neurosci. 2015;17(4):391-401. PMID: 26869840.
via Brain Blogger Read More Here..Wednesday, 25 January 2017
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GP full-time workforce numbers dropped last year
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Tuesday, 24 January 2017
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Why You Should Eat Breakfast Post-Workout to Burn More Fat
SPONSORED BY BELVITA
I'm a morning exerciser. Sometimes it's hard to set my alarm for an early wake-up (and not hit snooze when it goes off). But I work out because I love the way it makes me feel—stronger, faster, healthier, less stressed, the list goes on. Regular exercise does more than help you lose and maintain your weight. It also helps keep your brain sharp. And, studies indicate that people who regularly exercise live longer. Since I want to get the most out of each workout I eat breakfast after my workout.
Exercise Rates Often Decline After Cancer Diagnosis
Source: HealthDay via Exercise and Physical Fitness New Links: MedlinePlus RSS Feed Read More Here..
Brazil sees sharp rise in yellow fever cases
Bed-blocking patient evicted after two years 'did not want to stay'
The incredible invisible bed crisis
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WHO Executive Board agrees on an initial short list of candidates to the post of WHO Director-General
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Britons urged to get back on two wheels
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