Having high insulin levels may be more than tough to manage when you have diabetes: New research shows it also appears to raise the risk of pancreatic cancer.

In the study, scientists found excessive insulin levels overstimulated pancreatic acinar cells, which produce digestive juices. This overstimulation triggers inflammation that turns these cells into precancerous cells.

“Alongside the rapid increase in both obesity and type 2 diabetes, we’re seeing an alarming rise in pancreatic cancer rates,” said co-senior study author James Johnson, a professor in the Department of Cellular and Physiological Sciences and interim director of the Life Sciences Institute at the University of British Columbia (UBC) in Vancouver.

“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,” Johnson said in a university news release.

The study focused on pancreatic ductal adenocarcinoma (PDAC). This is the most prevalent pancreatic cancer. It is highly aggressive with a five-year survival rate of less than 10%. By 2030, PDAC is expected to become the second leading cause of cancer-related deaths.

The new study sheds light on the role of insulin and its receptors in pancreatic cancer risk.

“We found that hyperinsulinemia [high insulin levels] directly contributes to pancreatic cancer initiation through insulin receptors in acinar cells,” said study first author Anni Zhang, who recently graduated with a PhD from UBC and now is a post-doc researcher at Stanford University in California. “The mechanism involves increased production of digestive enzymes, leading to heightened pancreatic inflammation.”

Knowing this may help guide new cancer prevention strategies, and it may also lead to treatments that target insulin receptors in acinar cells.

“We hope this work will change clinical practice and help advance lifestyle interventions that can lower the risk of pancreatic cancer in the general population,” said co-senior study author Janel Kopp, an assistant professor in the Department of Cellular and Physiological Sciences at UBC.

“This research could also pave the way for targeted therapies that modulate insulin receptors to prevent or slow the progression of pancreatic cancer,” she said in the release.

The findings were published Oct. 31 in the journal Cell Metabolism.

The research team is now involved in a clinical trial in collaboration with researchers at BC Cancer and the Pancreas Centre BC, to help patients diagnosed with PDAC control their blood sugar and circulating insulin levels with the help of an endocrinologist.

The findings may also have implications for other cancers associated with obesity and type 2 diabetes, the authors said.

“Colleagues in Toronto have shown similar connections between insulin and breast cancer,” Johnson said. “In the future, we hope to determine whether and how excess insulin might contribute to other types of obesity- and diabetes-driven cancers.”

More information

The U.S. National Cancer Institute has more on pancreatic cancer.

SOURCE: University of British Columbia, news release, Oct. 31, 2023