Symptom: Diabetes and Pancreatic cancer

Approximately 20.8 million people or 7% of the population in the United States has diabetes.  It is estimated that 14.6 million have been diagnosed, but unfortunately, 6.2 million people, or nearly one-third, are unaware that they have the disease.

What is diabetes?
Diabetes is a disease in which the body does not make or properly use a pancreatic hormone called insulin.  Insulin, a hormone secreted by the pancreas, helps the body utilize glucose (sugar) efficiently.  Normally, insulin allows glucose to enter cells and be used for energy.  In the case of diabetes, the body either does not produce enough insulin or the amount that is produced is not fully effective.  Instead of entering cells, the glucose remains in the blood resulting in high blood glucose levels.  Diabetes can cause major health problems.  High blood glucose can lead to cell damage and long-term complications.

There are several types of diabetes.  Type 1 diabetes results from the body’s inability to produce insulin and accounts for approximately 5%-10% of those diagnosed.  Type 2 diabetes results from the body’s failure to properly use insulin combined with insulin deficiency and accounts for most diagnosed cases of diabetes in the United States.  Pre-diabetes occurs when a person’s blood glucose levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes.  Approximately 54 million Americans are pre-diabetics.  Other types of diabetes result from specific genetic conditions, surgery, drugs, malnutrition, infections and other illnesses.

How does diabetes relate to pancreatic cancer?
Individuals with pancreatic cancer are at risk for diabetes or glucose intolerance.  For pancreatic cancer patients, diabetes may be either a symptom or result of the tumor.  Pancreatic cancer is two times more likely to occur in people who have diabetes than in people who do not have diabetes.  In pancreatic cancer patients who have had diabetes for less than five years, it is unclear if the diabetes contributed to the cancer or if the precancerous cells caused the diabetes.  The tumor may impair insulin secretion by the pancreas; in this case, surgical removal of the tumor may cure the diabetes.  Alternately, surgical removal of part, or all, of the pancreas may result in diabetes, since cells that produce insulin have been removed by the surgery.

What foods may help control diabetes?
People with diabetes and cancer have special nutritional needs.  An individual can have a positive influence on his/her blood glucose and overall health by choosing foods wisely.  By eating well-balanced meals in the correct amounts, individuals can keep their blood glucose level as close to normal (non-diabetes level) as possible.  The proper balance of food, medication, physical activity and nutritional supplements are needed to improve blood glucose control, physical healing, weight maintenance and quality of life.  No single food will supply all the nutrients a body needs, so good nutrition means eating a variety of foods.

It is important to eat foods from each group at each meal every day.  Foods are divided into five main groups:

• Fruits and vegetables (oranges, apples, bananas, carrots, and spinach)
• Whole grains, cereals, and bread (wheat, rice, oats, bran and barley)
• Dairy products (milk, cheese, and yogurt)
• Meats and meat substitutes (fish, poultry, eggs, dried beans, and nuts)
• Fats and oils (oil, butter, and margarine)

By eating foods from each food group at each meal, an individual ensures that the body has a proper balance of all the nutrients (carbohydrates, proteins, fats, vitamins, and minerals) it needs to function.  Eating meals and snacks at regular times is also necessary for controlling blood sugar levels.

Carbohydrate calories are best utilized by the body for energy, while protein from the diet is used for building lean body mass.  Choosing foods with complex carbohydrates, such as starch and fiber, may help in the control of blood glucose levels.  Fiber comes from plants and may help to lower blood glucose and blood-fat levels.  Foods high in fiber include bran cereals, cooked beans and peas, whole-grain bread, fruits and vegetables.  Eating high-protein foods at each meal and evening snack also may help in the control of blood sugar.  Healthy choices are dried beans, peas, lentils, lean meats and low-fat dairy products.

Including small amounts of healthy fat may also help control blood sugar levels.  Foods high in healthy fats include:  oils: olive, canola, and peanut, olives, avocados, nuts and seeds and fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna and salmon.

Should diabetics with pancreatic cancer avoid eating all sugar?
No, unless this is the advice of a physician or dietitian.  Cutting out sugar in the patient’s diet will not result in the death of cancer cells.  Glucose is the basic food source for all cells, including cancer cells, and is provided by eating foods containing carbohydrates.  It may be necessary to avoid foods high in simple sugars if the individual experiences problems with watery diarrhea after eating such foods.  Foods high in simple sugars include rich desserts, ice cream, candy, sweetened drinks and fruits packed in syrup. 

If the patient is experiencing weight loss unrelated to blood sugar control, it may caused by cancer-induced weight loss, called cancer cachexia.  In this situation, chemical changes in the body cause the breakdown of body fat and lean body mass to make energy for cancer and healthy cells.  It may be necessary to introduce another supplement into the diet.  Consult your doctor or dietitian to find out which supplement is right for you.

Who can help me create an appropriate diet?
If you or a loved one has pancreatic cancer and diabetes, consider consulting a registered dietitian (RD) who understands these two conditions.  A registered dietitian has expertise in how the body uses food and can teach you how the food you eat affects blood glucose level and how to coordinate diabetes medications and meal schedules.  A registered dietitian can also provide guidance about nutritional supplements that may be helpful for patients experiencing weight loss related to the cancer.

Please consult with a physician for direction on the proper management of diabetes. 

Other Resources:
American Diabetes Association

The information and services provided by the Pancreatic Cancer Action Network, Inc. are for informational purposes only.  The information and services are not intended to be substitutes for professional medical advice, diagnosis or treatment.  If you are ill, or suspect that you are ill, see a doctor immediately!  The Pancreatic Cancer Action Network does not recommend nor endorse any specific physicians, products or treatments even though they may be mentioned on this site.  081001