From Persisting Diabetes to the Diagnosis of Pancreatic Cancer: A Case Report

The diagnosis of new-onset diabetes mellitus (DM) in individuals with a consumptive syndrome warrants a comprehensive and systematic etiological investigation. This article presents the case of a 45-year-old male, smoker, with a history of a treated C hepatitis virus, diagnosed with type 2 diabetes, accompanied by complaints of fatigue, anorexia, and unintentional weight loss. Despite an initial workup by the general practitioner, including colonoscopy, endoscopy, and abdominal-pelvic CT scan, no neoplastic etiology was identified. A few months later, due to worsening pain and continued weight loss, along with multiple visits to the emergency room, he was referred for an internal medicine consultation for further evaluation. During this investigation, stage IV pancreatic cancer was diagnosed, with multiple organ involvement, and the patient was indicated for best supportive care. The patient passed away four months after the diagnosis. Through this clinical case, the authors aim to highlight that in cases of newly diagnosed diabetes mellitus with poor control despite therapy and negative imaging results, and associated risk factors, such as tobacco and virus C hepatitis, continuous etiological investigation is crucial, particularly when there is a failure to achieve metabolic control despite appropriate pharmacological treatment and diet.