Systematic Review Links Pancreatic Cancer Surgery to Postoperative Diabetes Risk
News, Oncoscience
December 19, 2025“The development of NODM after partial pancreatic resections for pancreatic adenocarcinoma is a severe complication that requires prompt diagnosis, careful monitoring and systematic management.”
BUFFALO, NY — December 19, 2025 — A new review was published in Volume 12 of Oncoscience on December 8, 2025, titled “Incidence and risk factors for new-onset diabetes mellitus (NODM) in post-pancreatectomy patients diagnosed with pancreatic adenocarcinoma (PAC): A systematic review.”
This systematic review, led by Adavikolanu Kesava Ramgopal from AIIMS Mangalagiri and Kondeti Ajay Kumare from AIIMS Bibinagar, analyzed 45 previously published studies to assess the risk of developing new-onset diabetes mellitus (NODM) after surgery for pancreatic adenocarcinoma. The findings show that nearly one in four patients developed diabetes following partial removal of the pancreas. The review emphasizes the need to recognize diabetes as a common and serious complication after pancreatic surgery, particularly in patients with known risk factors.
Pancreatic adenocarcinoma is one of the most aggressive forms of cancer, with limited treatment options and low survival rates. Surgical procedures such as pancreaticoduodenectomy and distal pancreatectomy are standard treatments aimed at removing cancerous tissue. However, because the pancreas is essential for regulating blood sugar, these procedures may significantly affect endocrine function, leading to diabetes.
“45 quantitative studies were analysed, of which 16 (35.5%) were prospective studies and 29 (64.5%) were retrospective studies.”
The review examined studies published between 2000 and 2025 involving patients who underwent either pancreaticoduodenectomy (removal of the head of the pancreas) or distal pancreatectomy (removal of the tail and body). The overall incidence of NODM was 24.5%. Among patients who underwent pancreaticoduodenectomy, 23.2% developed diabetes, while the rate increased to 26.3% in those who had a distal pancreatectomy. This difference is likely due to the loss of insulin-producing cells that are more concentrated in the tail and body of the pancreas.
Several risk factors for developing NODM after surgery were also identified in the review. These include older age, high body mass index (BMI), elevated blood sugar before surgery, a history of chronic pancreatitis, and a smaller remaining portion of the pancreas after resection. Postoperative complications, such as infection or inflammation, also increased the risk.
The authors highlight the importance of early screening and long-term blood sugar monitoring in patients undergoing pancreatic surgery. Recognizing which patients are more vulnerable can help guide postoperative care and reduce the long-term burden of diabetes.
By summarizing evidence from multiple countries and studies, this review provides valuable insight into the frequency and causes of diabetes after pancreatic cancer surgery. The authors call for larger prospective studies and the development of standardized monitoring protocols to improve outcomes for these patients.
DOI: https://doi.org/10.18632/oncoscience.637
Correspondence to: Kondeti Ajay Kumar – ajay.radonc@aiimsbibinagar.edu.in
Keywords: cancer, pancreatectomy, pancreatic adenocarcinoma, diabetes mellitus
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