Deep Cancers in Uncontrolled Diabetes and Weight Loss

An unexpected weight loss can be the first manifestation of deep cancers, more frequent in diabetes.How many are detected by a Thoraco-Abdominal-Pelvic Scanner (TAP)?From the register of TAP-scanners performed in our diabetology department from 2010 to 2019, we selected those indicated for unexplained weight loss.Binary logistic regression analysis was performed to identify clinical and biological characteristics related to cancer.The 359 patients were mainly men (61%), 58±12 years old, BMI: 26.6±6.0kg/m 2 , with 8±11 years duration of diabetes, poorly controlled (HbA1c: 10.6±2.8%), with frequent vascular complications (62.2%).The scanner led to 22 (6.1%) diagnosis of cancers: 8 pancreatic, 7 pulmonary, 3 hepatic and 4 renal.As compared to cancer-free, these patients had greater weight loss: -21±12 kg vs. -15±11, p=0.02.They did not differ for other clinical and biological characteristics, except lower HbA1c and higher liver enzymes.Adjusted for age and gender, maximal weight losses more than -13 kg (HR: 3.28, 95%CI: 1.18-9.10)and abnormal were related to the detection of a cancer.No cancer was detected among the 63 patients with weight losses lower than 13 kg and normal GGTs.Among 359 patients admitted for uncontrolled diabetes and weight loss, the CT-scan detected 22 deep cancers (6.1%), especially in patients with important weight loss and abnormal GGTs. Highlights• Weight loss and deep cancers are more frequent in subjects with diabetes.• In 359 subjects admitted for uncontrolled diabetes and weight loss, we performed a CT-scanner and found 22 deep cancers (6.2%): pancreas, lungs, liver and kidneys.• The cancers were more frequent for important weight loss when Gamma-Glutaryl-Transferases were increased.