The complex interplay between diabetes mellitus and pancreatic carcinogenesis: deciphering multifactorial mechanisms and identifying emerging therapeutic vulnerabilities.

Diabetes mellitus (DM) represents a significant global public health challenge, as economic development and changes in modern dietary habits have contributed to a rising prevalence of DM patients. Pancreatic cancer (PC), a highly aggressive malignancy, exhibits a 5-year survival rate of approximately 10%. The intricate and perilous relationship between DM and the onset and progression of PC is increasingly being elucidated, revealing a complex underlying network that encompasses multiple dimensions, including molecular signaling, metabolism, endocrinology, immunity, microbiota, and tumor microenvironment formation. Consequently, this review aims to delineate the overarching framework of the extensive relational network between DM and PC, focusing on the aforementioned aspects. Specifically, this review highlights the promoting effects of DM on the carcinogenic process of PC, emphasizing the complexity of the DM-PC interaction and identifying potential therapeutic targets for intervention.