Evaluation of a Mixed Meal Test for Diagnosis and Characterization of Type 3c Diabetes Mellitus Secondary to Pancreatic Cancer and Chronic Pancreatitis, DETECT Study

Inclusion Criteria

• All patients must sign an informed consent indicating that they are aware of the investigational nature of this study. Patients must have signed an authorization for the release of their protected health information.
• Patients must be ages >= 30 and < 85.
• Patients must have a diagnosis of one of the following based on study definitions; * New onset diabetes (< 3 years) in subjects with pancreatic cancer (PDAC); * New onset diabetes (< 3 years) in subjects with chronic pancreatitis; * New onset diabetes (< 3 years) in subjects without pancreatic disease (i.e., T2DM); * Long standing T2DM (>= 3 years) without pancreatic disease; * Long standing diabetes (>= 3 years) in subjects with PDAC; * Long standing diabetes (>= 3 years) subjects with chronic pancreatitis * Non-diabetic subjects with PDAC * Non-diabetic subjects with chronic pancreatitis * Non-diabetic controls without pancreatic disease

Exclusion Criteria

• Patients must not have any significant medical illnesses (including diabetes) that in the investigator's opinion cannot be adequately controlled with appropriate therapy or would compromise the patient's ability to tolerate study interventions.
• Diabetes not stable enough to permit holding of diabetes medications in subjects undergoing mixed meal tolerance testing.
• Subjects taking higher doses of insulin (>= 0.75 unit/kg/day). (Criterion is not applicable for PDAC subjects undergoing fasting only blood collection)
• Subjects in the non-pancreatic disease subgroup on longer acting agents, including thiazolidinediones and once-weekly GLP-1 agonists (Bydureon [exenatide], Ozempic [semaglutide], Trulicity [dulaglutide]). (Criterion is not applicable for subjects in the CP and PDAC groups]
• Patients currently receiving oral steroid medications.
• Hospitalization for acute pancreatitis within 2 months before study visit (with the exception of subjects enrolled into the PDAC group as this may be a symptom of the disease). (Criterion is not applicable for PDAC subjects undergoing fasting only blood collection)
• The presence of a symptomatic cyst in subjects with CP. (Criterion is not applicable for PDAC subjects undergoing fasting only blood collection; this includes cancer arising from a mucinous cystic lesion)
• Any subject with a pancreatic cancer histologic subtype other than adenocarcinoma (e.g., subjects with pancreatic neuroendocrine tumors are excluded).
• Previous pancreatic surgery (including total pancreatectomy, pancreaticoduodenectomy, distal pancreatectomy, pancreaticojejunostomy, enucleation, or Frey procedure). (Criterion is not applicable for CP subjects with diabetes who have a history of pancreaticoduodenectomy, pancreaticojejunostomy, distal pancreatectomy, or Frey)
• Previous treatment for pancreatic cancer, including chemotherapy or radiation.
• Previous vagotomy or gastric surgery, including endoscopic gastric reduction procedures. (Criterion is not applicable for PDAC subjects undergoing fasting only blood collection)
• Previous diagnosis of gastroparesis. (Criterion is not applicable for PDAC subjects undergoing fasting only blood collection)
• Patients on treatment for any cancer (except non-melanoma skin cancer or carcinoma in-situ of the cervix).
• Allergy or intolerance to ingredients in Boost drink in subjects undergoing mixed meal testing. (Criterion is not applicable for PDAC subjects undergoing fasting only blood collection)