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Exp Clin Endocrinol Diabetes 2008; 116: S7-S12
DOI: 10.1055/s-2008-1080918
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© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Pancreatic Disorders and Diabetes Mellitus

R. Meisterfeld 1 , 2 , F. Ehehalt 1 , 2 , H. D. Saeger 1 , M. Solimena 2 , 3 , 4
  • 1Department of Visceral, Thoracic and Vascular Surgery, Medical School Carl Gustav Carus, University of Technology Dresden, Dresden, Germany
  • 2Experimental Diabetology, Medical School Carl Gustav Carus, University of Technology Dresden, Dresden, Germany
  • 3Department of Internal Medicine III, Medical School Carl Gustav Carus, University of Technology Dresden, Dresden, Germany
  • 4Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany
Further Information

Publication History

received 14.03.2008 first decision 16.04.2008

accepted 27.05.2008

Publication Date:
05 September 2008 (online)

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Abstract

Diabetes mellitus is a common disease among patients with pancreatic cancer and chronic pancreatitis, disorders of the exocrine pancreas. Different clinical features of diabetes are associated with these two conditions: hyperinsulinemia and peripheral insulin resistance are the prevailing diabetic traits in pancreatic cancer, whereas reduced islet cell mass and impaired insulin secretion are typically observed in chronic pancreatitis. Whether or not a causal relationship exists between diabetes and pancreatic carcinoma is an intriguing but unanswered question. Diabetes often precedes pancreatic cancer and is thus regarded as a potential risk factor for malignancy. Conversely, pancreatic cancer may secrete diabetogenic factors. Given these findings, there is increasing interest in whether close monitoring of the glycemic profile may aid early detection of pancreatic tumor lesions.

Key words

pancreatic cancer - chronic pancreatitis - diabetes mellitus

References

  • 1 ADA . Type 2 diabetes in children and adolescents. American Diabetes Association.  Diabetes Care. 2000;  23 ((3)) 381-389
    CrossrefPubMedGoogle Scholar
  • 2 Bank S. Chronic pancreatitis: clinical features and medical management.  Am J Gastroenterol. 1986;  81 ((3)) 153-167
    PubMedGoogle Scholar
  • 3 Basso D, Greco E, Fogar P, Pucci P, Flagiello A, Baldo G, Giunco S, Valerio A, Navaglia F, Zambon CF, Falda A, Pedrazzoli S, Plebani M. Pancreatic cancer-derived S-100A8 N-terminal peptide: a diabetes cause?.  Clin Chim Acta. 2006;  372 ((1–2)) 120-128
    CrossrefPubMedGoogle Scholar
  • 4 Basso D, Greco E, Fogar P, Pucci P, Flagiello A, Baldo G, Giunco S, Valerio A, Navaglia F, Zambon CF, Pedrazzoli S, Plebani M. Pancreatic cancer-associated diabetes mellitus: an open field for proteomic applications.  Clin Chim Acta. 2005;  357 ((2)) 184-189
    CrossrefPubMedGoogle Scholar
  • 5 Basso D, Valerio A, Seraglia R, Mazza S, Piva MG, Greco E, Fogar P, Gallo N, Pedrazzoli S, Tiengo A, Plebani M. Putative pancreatic cancer-associated diabetogenic factor: 2030 MW peptide.  Pancreas. 2002;  24 ((1)) 8-14
    CrossrefPubMedGoogle Scholar
  • 6 Bonelli L, Aste H, Bovo P, Cavallini G, Felder M, Gusmaroli R, Morandini E, Ravelli P, Briglia R, Lombardo L, Micheli A De, Pugliese V. Exocrine pancreatic cancer, cigarette smoking, and diabetes mellitus: A case-control study in Northern Italy.  Pancreas. 2003;  27 ((2)) 143-149
    CrossrefPubMedGoogle Scholar
  • 7 Bowker SL, Majumdar SR, Veugelers P, Johnson JA. Increased cancer-related mortality for patients with type 2 diabetes who use sulfonylureas or insulin.  Diabetes Care. 2006;  29 ((2)) 254-258
    CrossrefPubMedGoogle Scholar
  • 8 Brand RE, Lerch MM, Rubinstein WS, Neoptolemos JP, Whitcomb DC, Hruban RH, Brentnall TA, Lynch HT, Canto MI. Advances in counselling and surveillance of patients at risk for pancreatic cancer.  Gut. 2007;  56 ((10)) 1460-1469
    CrossrefPubMedGoogle Scholar
  • 9 Bright R. Cases and observations connected with disease of the pancreas and duodenum.  Med Chir Trans. 1833;  18 1-56
    PubMedGoogle Scholar
  • 10 Bruns C, Diebold J, Heinemann V, Wilkowski R, Wagner A, Schmid R. Karzinome des exokrinen Panreas und der periampullären Region. In: Sendler, A. (ed). Manual Gastrointestinale Tumoren – Empfehlungen zur Diagnostik, Therapie und Nachsorge. München: Zuckschwerdt Verlage 2006: 77-99
    Google Scholar
  • 11 Büchler MW, Friess H, Müller MW, Wheatley AM, Beger HG. Randomized trial of duodenum-preserving pancreatic head resection versus pylorus-preserving Whipple in chronic pancreatitis.  Am J Surg. 1995;  169 ((1)) 65-69 , ; discussion 69–70
    CrossrefPubMedGoogle Scholar
  • 12 Chari ST, Klee GG, Miller LJ, Raimondo M, Magno EP Di. Islet amyloid polypeptide is not a satisfactory marker for detecting pancreatic cancer.  Gastroenterology. 2001;  121 ((3)) 640-645
    CrossrefPubMedGoogle Scholar
  • 13 Chari ST, Leibson CL, Rabe KG, Ransom J, Andrade M de, Petersen GM. Probability of pancreatic cancer following diabetes: a population-based study.  Gastroenterology. 2005;  129 ((2)) 504-511
    CrossrefPubMedGoogle Scholar
  • 14 Chari ST, Leibson CL, Rabe KG, Timmons LJ, Ransom J, Andrade M de, Petersen GM. Pancreatic cancer-associated diabetes mellitus: prevalence and temporal association with diagnosis of cancer.  Gastroenterology. 2008;  134 ((1)) 95-101
    CrossrefPubMedGoogle Scholar
  • 15 Czyzyk A, Szczepanik Z. Diabetes mellitus and cancer.  Eur J Intern Med. 2000;  11 ((5)) 245-252
    PubMedGoogle Scholar
  • 16 Damiano J, Bordier L, Le Berre JP, Mrgery J, Dupuy O, Mayaudon H, Bauduceau B. Should pancreas imaging be recommanded in patients over 50 years when diabetes is discovered because of acute symptoms?.  Diabetes Metab. 2004;  30 ((2)) 203-207
    CrossrefPubMedGoogle Scholar
  • 17 Davalli AM, Pontiroli AE, Bertuzzi F, Pozza G, Socci C, Carlo V Di, Freschi M. In vitro function of human islets isolated from the pancreas of a cadaveric donor with diabetes mellitus secondary to chronic pancreatitis.  Pancreas. 1994;  9 ((1)) 134-136
    PubMedGoogle Scholar
  • 18 Everhart J, Wright D. Diabetes mellitus as a risk factor for pancreatic cancer. A meta-analysis.  JAMA. 1995;  273 ((20)) 1605-1609
    CrossrefPubMedGoogle Scholar
  • 19 Fisher WE, Boros LG, Schirmer WJ. Insulin promotes pancreatic cancer: evidence for endocrine influence on exocrine pancreatic tumors.  J Surg Res. 1996;  63 ((1)) 310-313
    CrossrefPubMedGoogle Scholar
  • 20 Fisher WE, Muscarella P, Boros LG, Schirmer WJ. Variable effect of streptozotocin-diabetes on the growth of hamster pancreatic cancer (H2T) in the Syrian hamster and nude mouse.  Surgery. 1998;  123 ((3)) 315-320
    PubMedGoogle Scholar
  • 21 Fogar P, Basso D, Pasquali C, Piva MG, Brigato L, Paoli M De, Galeotti F, Corsini A, Plebani M. Portal but not peripheral serum levels of interleukin 6 could interfere with glucose metabolism in patients with pancreatic cancer.  Clin Chim Acta. 1998;  277 ((2)) 181-189
    CrossrefPubMedGoogle Scholar
  • 22 Fogar P, Pasquali C, Basso D, Sperti C, Panozzo MP, Tessari G, DAngeli F, Del Favero G, Plebani M. Diabetes mellitus in pancreatic cancer follow-up.  Anticancer Res. 1994;  14 ((6B)) 2827-2830
    PubMedGoogle Scholar
  • 23 Friedman GD, Eeden SK van den. Risk factors for pancreatic cancer: an exploratory study.  Int J Epidemiol. 1993;  22 ((1)) 30-37
    CrossrefPubMedGoogle Scholar
  • 24 Frye JN, Inder WJ, Dobbs BR, Frizelle FA. Pancreatic cancer and diabetes: is there a relationship? A case-controlled study.  Aust N Z J Surg. 2000;  70 ((10)) 722-724
    CrossrefPubMedGoogle Scholar
  • 25 Fryzek JP, Garabrant DH, Schenk M, Kinnard M, Greenson JK, Sarkar FH. The association between selected risk factors for pancreatic cancer and the expression of p53 and K-ras codon 12 mutations.  Int J Gastrointest Cancer. 2006;  37 ((4)) 139-145
    PubMedGoogle Scholar
  • 26 Gavin JR, Alberti KGMM, Davidson MB, DeFronzo RA, Drash A, Gabbe SG, Genuth S, Harris MI, Kahn R, Keen H, Knowler WC, Lebovitz H, Maclaren NK, Palmer JP, Raskin P, Rizza RA, Stern MP. Report of the expert committee on the diagnosis and classification of diabetes mellitus.  Diabetes Care. 2003;  S5-20
    CrossrefPubMedGoogle Scholar
  • 27 Goto M, Nakano I, Kimura T, Miyahara T, Kinjo M, Nawata H. New chronic pancreatitis model with diabetes induced by cerulein plus stress in rats.  Dig Dis Sci. 1995;  40 ((11)) 2356-2363
    CrossrefPubMedGoogle Scholar
  • 28 Gullo L. Diabetes and the risk of pancreatic cancer.  Ann Oncol. 1999;  10 ((Suppl 4)) 79-81
    PubMedGoogle Scholar
  • 29 Gullo L, Pezzilli R, Morselli-Labate AM. Diabetes and the risk of pancreatic cancer. Italian Pancreatic Cancer Study Group.  N Engl J Med. 1994;  331 ((2)) 81-84
    CrossrefPubMedGoogle Scholar
  • 30 Gupta S, Vittinghoff E, Bertenthal D, Corley D, Shen H, Walter LC, MacQuaid K. New-onset diabetes and pancreatic cancer.  Clin Gastroenterol Hepatol. 2006;  4 ((11)) 1366-1372 , ; quiz 1301.
    CrossrefPubMedGoogle Scholar
  • 31 Gupta V, Toskes PP. Diagnosis and management of chronic pancreatitis.  Postgrad Med J. 2005;  81 ((958)) 491-497
    CrossrefPubMedGoogle Scholar
  • 32 Hedetoft C, Sheikh SP, Larsen S, Holst JJ. Effect of glucagon-like peptide 1(7–36) amide in insulin-treated patients with diabetes mellitus secondary to chronic pancreatitis.  Pancreas. 2000;  20 ((1)) 25-31
    CrossrefPubMedGoogle Scholar
  • 33 Hjalgrim H, Frisch M, Ekbom A, Kyvik KO, Melbye M, Green A. Cancer and diabetes – a follow-up study of two population-based cohorts of diabetic patients.  J Intern Med. 1997;  241 ((6)) 471-475
    CrossrefPubMedGoogle Scholar
  • 34 Hull RL, Westermark GT, Westermark P, Kahn SE. Islet amyloid: a critical entity in the pathogenesis of type 2 diabetes.  J Clin Endocrinol Metab. 2004;  89 ((8)) 3629-3643
    CrossrefPubMedGoogle Scholar
  • 35 Huxley R, Ansary-Moghaddam A, Berrington de Gonzalez A, Barzi F, Woodward M. Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies.  Br J Cancer. 2005;  92 ((11)) 2076-2083
    CrossrefPubMedGoogle Scholar
  • 36 Isaksson B, Strommer L, Friess H, Buchler MW, Herrington MK, Wang F, Zierath JR, Wallberg-Henriksson H, Larsson J, Permert J. Impaired insulin action on phosphatidylinositol 3-kinase activity and glucose transport in skeletal muscle of pancreatic cancer patients.  Pancreas. 2003;  26 ((2)) 173-177
    CrossrefPubMedGoogle Scholar
  • 37 Ishikawa O, Ohhigashi H, Wada A, Tateishi R, Ishiguro S, Okano Y, Sasaki Y, Imaoka S, Koyama H, Iwanaga T. Morphologic characteristics of pancreatic carcinoma with diabetes mellitus.  Cancer. 1989;  64 ((5)) 1107-1112
    CrossrefPubMedGoogle Scholar
  • 38 Ishikawa O, Ohigashi H, Imaoka S, Nakai I, Mitsuo M, Weide L, Pour PM. The role of pancreatic islets in experimental pancreatic carcinogenicity.  Am J Pathol. 1995;  147 ((5)) 1456-1464
    PubMedGoogle Scholar
  • 39 Ito T, Otsuki M, Itoi T, Shimosegawa T, Funakoshi A, Shiratori K, Naruse S, Kuroda Y. Pancreatic diabetes in a follow-up survey of chronic pancreatitis in Japan.  J Gastroenterol. 2007;  42 ((4)) 291-297
    CrossrefPubMedGoogle Scholar
  • 40 Klöppel G, Bommer G, Commandeur G, Heitz P. The endocrine pancreas in chronic pancreatitis. Immunocytochemical and ultrastructural studies.  Virchows Arch A Pathol Anat Histol. 1978;  377 ((2)) 157-174
    CrossrefPubMedGoogle Scholar
  • 41 Litwin J, Dobrowolski S, Orlowska-Kunikowska E, Sledzinski Z. Changes in glucose metabolism after Kausch-Whipple pancreatectomy in pancreatic cancer and chronic pancreatitis patients.  Pancreas. 2008;  36 ((1)) 26-30
    PubMedGoogle Scholar
  • 42 Liu J, Kazakoff K, Pour PM, Adrian TE. The intracellular mechanism of insulin resistance in the hamster pancreatic ductal adenocarcinoma model.  Pancreas. 1998;  17 ((4)) 359-366
    PubMedGoogle Scholar
  • 43 Liu J, Knezetic JA, Strommer L, Permert J, Larsson J, Adrian TE. The intracellular mechanism of insulin resistance in pancreatic cancer patients.  J Clin Endocrinol Metab. 2000;  85 ((3)) 1232-1238
    CrossrefPubMedGoogle Scholar
  • 44 Malka D, Hammel P, Sauvanet A, Rufat P, O’Toole D, Bardet P, Belghiti J, Bernades P, Ruszniewski P, Levy P. Risk factors for diabetes mellitus in chronic pancreatitis.  Gastroenterology. 2000;  119 ((5)) 1324-1332
    CrossrefPubMedGoogle Scholar
  • 45 Michaud DS, Wolpin B, Giovannucci E, Liu S, Cochrane B, Manson JE, Pollak MN, Ma J, Fuchs CS. Prediagnostic plasma C-peptide and pancreatic cancer risk in men and women.  Cancer Epidemiol Biomarkers Prev. 2007;  16 ((10)) 2101-2109
    CrossrefPubMedGoogle Scholar
  • 46 Monami M, Lamanna C, Pala L, Bardini G, Cresci B, Francesconi P, Balzi D, Marchionni N, Rotella CM, Mannucci E. Treatment with insulin secretagogues and cancer-related mortality in type 2 diabetic patients a retrospective cohort study.  Exp Clin Endocrinol Diabetes. 2008;  116 ((3)) 184-189
    Article in Thieme ConnectPubMedGoogle Scholar
  • 47 Mossner J, Logsdon CD, Williams JA, Goldfine ID. Insulin, via its own receptor, regulates growth and amylase synthesis in pancreatic acinar AR42J cells.  Diabetes. 1985;  34 ((9)) 891-897
    CrossrefPubMedGoogle Scholar
  • 48 Nyboe Andersen B, Krarup T, Thorsgaard Pedersen NT, Faber OK, Hagen C, Worning H. B cell function in patients with chronic pancreatitis and its relation to exocrine pancreatic function.  Diabetologia. 1982;  23 ((2)) 86-89
    CrossrefPubMedGoogle Scholar
  • 49 Oosterwijk C, Hulst KL van, Visser CJ, Woutersen RA, Lips CJ, Tweel JG van den, Hoppener JW. Pancreatic cancer in rats and hamsters does not induce IAPP-related hyperglycaemia.  Int J Cancer. 1997;  72 ((4)) 637-641
    CrossrefPubMedGoogle Scholar
  • 50 Opie E. On the relation of chronic interstitial pancreatitis to the islands of Langerhans and to diabetes mellitus.  J exp Med. 1901;  5 ((4)) 397-428
    CrossrefPubMedGoogle Scholar
  • 51 Pelaez-Luna M, Takahashi N, Fletcher JG, Chari ST. Resectability of presymptomatic pancreatic cancer and its relationship to onset of diabetes: a retrospective review of CT scans and fasting glucose values prior to diagnosis.  Am J Gastroenterol. 2007;  102 ((10)) 2157-2163
    CrossrefPubMedGoogle Scholar
  • 52 Permert J, Adrian TE, Jacobsson P, Jorfelt L, Fruin AB, Larsson J. Is profound peripheral insulin resistance in patients with pancreatic cancer caused by a tumor-associated factor?.  Am J Surg. 1993a;  165 ((1)) 61-66 , ; discussion 66–67
    CrossrefPubMedGoogle Scholar
  • 53 Permert J, Ihse I, Jorfeldt L, Schenck H von, Arnqvist HJ, Larsson J. Pancreatic cancer is associated with impaired glucose metabolism.  Eur J Surg. 1993b;  159 ((2)) 101-107
    PubMedGoogle Scholar
  • 54 Permert J, Larsson J, Fruin AB, Tatemoto K, Herrington MK, Schenck H von, Adrian TE. Islet hormone secretion in pancreatic cancer patients with diabetes.  Pancreas. 1997;  15 ((1)) 60-68
    PubMedGoogle Scholar
  • 55 Permert J, Larsson J, Westermark GT, Herrington MK, Christmanson L, Pour PM, Westermark P, Adrian TE. Islet amyloid polypeptide in patients with pancreatic cancer and diabetes.  N Engl J Med. 1994;  330 ((5)) 313-318
    CrossrefPubMedGoogle Scholar
  • 56 Permert J, Mogaki M, Andren-Sandberg A, Kazakoff K, Pour PM. Pancreatic mixed ductal-islet tumors. Is this an entity?.  Int J Pancreatol. 1992;  11 ((1)) 23-29
    PubMedGoogle Scholar
  • 57 Perrin MC, Terry MB, Kleinhaus K, Deutsch L, Yanetz R, Tiram E, Calderon R, Friedlander Y, Paltiel O, Harlap S. Gestational diabetes as a risk factor for pancreatic cancer: a prospective cohort study.  BMC Med. 2007;  5 25
    CrossrefPubMedGoogle Scholar
  • 58 Pour PM, Duckworth W, Carlson K, Kazakoff K. Insulin therapy prevents spontaneous recovery from streptozotocin-induced diabetes in Syrian hamsters. An autoradiographic and immunohistochemical study.  Virchows Arch A Pathol Anat Histopathol. 1990;  417 ((4)) 333-341
    CrossrefPubMedGoogle Scholar
  • 59 Pour PM, Stepan K. Modification of pancreatic carcinogenesis in the hamster model. VIII. Inhibitory effect of exogenous insulin.  J Natl Cancer Inst. 1984;  72 ((5)) 1205-1208
    PubMedGoogle Scholar
  • 60 Pour PM, Weide L, Liu G, Kazakoff K, Scheetz M, Toshkov I, Ikematsu Y, Fienhold MA, Sanger W. Experimental evidence for the origin of ductal-type adenocarcinoma from the islets of Langerhans.  Am J Pathol. 1997;  150 ((6)) 2167-2180
    PubMedGoogle Scholar
  • 61 Ragozzino M, Melton  3rd  LJ, Chu CP, Palumbo PJ. Subsequent cancer risk in the incidence cohort of Rochester, Minnesota, residents with diabetes mellitus.  J Chronic Dis. 1982;  35 ((1)) 13-19
    CrossrefPubMedGoogle Scholar
  • 62 Schneider MB, Matsuzaki H, Haorah J, Ulrich A, Standop J, Ding XZ, Adrian TE, Pour PM. Prevention of pancreatic cancer induction in hamsters by metformin.  Gastroenterology. 2001;  120 ((5)) 1263-1270
    CrossrefPubMedGoogle Scholar
  • 63 Silverman DT, Swanson CA, Gridley G, Wacholder S, Greenberg RS, Brown LM, Hayes RB, Swanson GM, Schoenberg JB, Pottern LM, Schwartz AG, Fraumeni  Jr  JF, Hoover RN. Dietary and nutritional factors and pancreatic cancer: a case-control study based on direct interviews.  J Natl Cancer Inst. 1998;  90 ((22)) 1710-1719
    CrossrefPubMedGoogle Scholar
  • 64 Slebos RJC, Hoppin JA, Tolbert PE, Holly EA, Brock JW, Zhang RH, Bracci PM, Foley J, Stockton P, MacGregor LM, Flake GP, Taylor JA. K-ras and p53 in pancreatic cancer: Association with Medical History, Histopathology, and Environmental Exposures in a Population-based Study.  Cancer Epidemiol Biomarkers Prev. 2000;  9 ((11)) 1223-1232
    PubMedGoogle Scholar
  • 65 Steer ML, Waxman I, Freedman S. Chronic pancreatitis.  N Engl J Med. 1995;  332 ((22)) 1482-1490
    CrossrefPubMedGoogle Scholar
  • 66 Stevens RJ, Roddam AW, Beral V. Pancreatic cancer in type 1 and young-onset diabetes: systematic review and meta-analysis.  Br J Cancer. 2007;  96 ((3)) 507-509
    CrossrefPubMedGoogle Scholar
  • 67 Tateishi K, Magno EP Di, Klee GG. Plasma islet amyloid polypeptide is not an effective tumor marker for pancreatic cancer even when protease inhibitors and rapid freezing of specimens are utilized.  Clin Chem. 2001;  47 ((11)) 2071-2073
    PubMedGoogle Scholar
  • 68 Uygur-Bayramicli O, Dabak R, Orbay E, Dolapcioglu C, Sargin M, Kilicoglu G, Guleryuzlu Y, Mayadagli A. Type 2 diabetes mellitus and CA 19-9 levels.  World J Gastroenterol. 2007;  13 ((40)) 5357-5359
    PubMedGoogle Scholar
  • 69 Wakasugi H, Funakoshi A, Iguchi H. Clinical observations of pancreatic diabetes caused by pancreatic carcinoma, and survival period.  Int J Clin Oncol. 2001;  6 ((1)) 50-54
    CrossrefPubMedGoogle Scholar
  • 70 Wang F, Gupta S, Holly EA. Diabetes mellitus and pancreatic cancer in a population-based case-control study in the San Francisco Bay Area, California.  Cancer Epidemiol Biomarkers Prev. 2006;  15 ((8)) 1458-1463
    CrossrefPubMedGoogle Scholar
  • 71 Westermark P, Wernstedt C, Wilander E, Hayden DW, O’Brien TD, Johnson KH. Amyloid fibrils in human insulinoma and islets of Langerhans of the diabetic cat are derived from a neuropeptide-like protein also present in normal islet cells.  Proc Natl Acad Sci USA. 1987;  84 ((11)) 3881-3885
    CrossrefPubMedGoogle Scholar
  • 72 WHO .Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus. Geneva 1999
  • 73 Woods SC, Lutz TA, Geary N, Langhans W. Pancreatic signals controlling food intake; insulin, glucagon and amylin.  Philos Trans R Soc Lond B Biol Sci. 2006;  361 ((1471)) 1219-1235
    CrossrefPubMedGoogle Scholar
  • 74 Zendehdel K, Nyren O, Ostenson CG, Adami HO, Ekbom A, Ye W. Cancer incidence in patients with type 1 diabetes mellitus: a population-based cohort study in Sweden.  J Natl Cancer Inst. 2003;  95 ((23)) 1797-1800
    CrossrefPubMedGoogle Scholar
  • 75 Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic.  Nature. 2001;  414 ((6865)) 782-787
    CrossrefPubMedGoogle Scholar

Correspondence

Prof. Dr. M. SolimenaMD, PhD 

Experimental Diabetology

Medical School Carl Gustav Carus

University of Technology Dresden

Fetscherstraße 74

01307 Dresden

Germany

Phone: +49/351/458 66 12

Fax: +49/351/458 63 30

Email: Michele.Solimena@tu-dresden.de

Correspondence

Prof. Dr. med. H. D. Saeger

Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie

Universitätsklinikum Carl Gustav Carus an der TU Dresden

Fetscherstraße 74

01307 Dresden

Germany

Phone: +49/351/458 27 42

Fax: +49/351/458 43 95

Email: Hans-Detlev.Saeger@uniklinikum-dresden.de

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