PanCan CGM
Research type
Research Study
Full title
A case-control study comparing glycaemic control in pancreatic cancer patients versus age matched healthy individuals using continuous glucose monitors.
IRAS ID
315235
Contact name
Elizabeth Wrench
Contact email
Sponsor organisation
Lancaster Universty
Duration of Study in the UK
0 years, 4 months, 23 days
Research summary
"Research Summary"
Introduction and rationale:
The pancreas has two key functions related to digestion and metabolism. The first function of the pancreas is to produce exocrine enzymes which are released into the small intestine to help with the digestion of food. The second function is to produce endocrine hormones, such as insulin and glucagon, which help regulate glycaemic control. Impaired glucose metabolism and pancreatic cancer is temporally and pathogenically linked, with pancreatic tumours altering the secretion of key glucose regulatory hormones. Improved glucose regulation and lower glucose concentrations 3 months post-diagnosis of pancreatic ductal adenocarcinoma, a type of pancreatic cancer, has shown to increase overall survival.The aim of this study is to continuously monitor blood glucose concentrations for a 7-day period in pancreatic cancer patients whilst they undergo their typical daily routines to compare this to age matched healthy individuals. This will help provide evidence as to what impact pancreatic cancer has on glycaemic control, whether continuous glucose monitors might be useful to regulate symptoms in patients.
The study:
A small subset of patients will have their blood glucose concentrations monitored via a continuous glucose monitor (DEXCOM) and these will be compared with an age matched control group of healthy volunteers. This will help identify whether an exercise medicine intervention could have beneficial impacts on blood glucose regulation, and this could potentially be an area for further research. 15 pancreatic cancer patients will have continuous glucose monitors fitted for 7 days, along with activity trackers and a food diary to monitor the impact of these factors on blood glucose concentrations. The control group of 15 healthy volunteers will carry out the same measures to allow for comparison.
Primary objectives:
• To investigate how glycaemic control differs between pancreatic cancer patients and healthy individuals over a 7-day period by utilising continuous glucose monitors."Summary of Results"
The results from this study highlight that individuals with pancreatic cancer experience sustained hyperglycaemia (high blood glucose concentrations) when compared to the matched healthy participants. High blood glucose concentrations were sustained at each point of the day - night (11pm - 8am), morning (9am-12pm), afternoon (1pm-5pm) and evening (6pm-10pm). As blood glucose concentrations were found to be higher in the morning, afternoon and evening, typically when an individual is more likely to have consumed food, suggests that individuals with pancreatic cancer are unable to process glucose from external sources. Blood glucose concentrations were also found to be higher during the night, typically when an individual is less likely to have consumed food, indicating that fasting blood glucose levels, even in the absence of an external glucose source, are higher than matched healthy individuals. This suggests that internal blood glucose control mechanisms are impaired in individuals with pancreatic cancer.
As this was a case control study and participants were advised to carry out their normal daily routine, individuals with pancreatic cancer completed significantly less steps than the healthy matched participants. This is therefore a limitation of this study as a higher level of activity can improve blood glucose regulation, as shown in the healthy participants.How has this study helped patients and researchers?
The study has helped to highlight that individuals with pancreatic cancer experience sustained high glucose levels at all times of day, and this can be monitored using continuous glucose monitors. This therefore indicates that future interventions need to focus on how blood glucose regulation can be improved in this patient group to improve quality of life and continuous glucose monitors can be used to monitor this.REC name
Wales REC 7
REC reference
22/WA/0212
Date of REC Opinion
2 Aug 2022
REC opinion
Further Information Favourable Opinion