Background: There may be a bidirectional association between glycaemia and pNETS. Pre-existing diabetes mellitus(DM) is a recognised risk factor for the development of pNETS. Prevalence of DM in pNETS has been reported as 12-26% depending on patient age and tumour location. DM due to pNETS is classified as type 3C pancreatogenic diabetes, Type 3D caused by hormone disorders or Type 3E induced by medications. Functional pNETS, medical therapies and pancreatic surgeries can also have an effect on glycaemic control. Regular HbA1c monitoring is required to identify and manage diabetes. The evidence base on DM and prognosis in pNET is not clear.
Aims: To review HbA1c monitoring in pNET patients at presentation and during follow-up.
Methods: Patients with pNET were identified using the Sheffield NET database. Data collected, included demographics, tumour grade and stage, treatment and HbA1c values. Data was analysed using excel and SPSS statistics. The audit was approved by the Clinical Effectiveness Unit project panel at STH, reference number:11559.
Results: 68 patients diagnosed with pNET from 2015-2022 were identified. Mean age at diagnosis was 62 years, 62% were male. 85% of patients had a non-functioning tumour, 43% had a grade 1 tumour (Ki-67 index), 37% had metastatic spread, 31% with liver metastasis. 52% of patients had surgical resection of the tumour, 49% of patients were treated with a somatostatin analogue, 25% treated with Lutathera. 22% of people in the cohort had a pre-existing diagnosis of diabetes, 1 patient had type 1 diabetes, 14 patients had type 2 diabetes. 21% (14/68) people diagnosed with PNET developed diabetes during follow-up. 12% (8/68) of patients required insulin, 5 of these patients had a pre-existing diagnosis of type 2 diabetes. 47% of patients had a HbA1c measured at diagnosis, 41% of patients diagnosed had annual HbA1c monitoring.
Conclusions: 21% of pNET patients developed diabetes. This is similar to other publications. Here, less then 50% of patients had a HbA1c measured at diagnosis or had annual HbA1c monitoring. We would recommend monitoring of HbA1c in functional and non-functional pNETs as the impact of Type 3 diabetes mellitus is metabolic, nutritional and prognostic.