Researchers from the University of British Columbia (UBC) have uncovered a direct connection between high insulin levels—common in people with obesity and Type 2 diabetes—and the development of pancreatic cancer.
Published in Cell Metabolism, the study offers the first clear explanation of how elevated insulin levels, a condition called hyperinsulinemia, can trigger changes in the pancreas that lead to cancer.
Pancreatic cancer, particularly pancreatic ductal adenocarcinoma (PDAC), is one of the most aggressive and deadly forms of cancer, with a five-year survival rate of less than 10%. Its incidence is rising quickly and is expected to become the second leading cause of cancer-related death by 2030.
“We’ve long known that obesity and Type 2 diabetes raise the risk of pancreatic cancer,” said Dr. James Johnson, a professor at UBC and co-senior author of the study. “Now we understand that excess insulin plays a key role in this dangerous link.”
The researchers discovered that when insulin levels remain chronically high, they overstimulate acinar cells in the pancreas. These cells normally produce digestive enzymes to help break down fats and proteins. But when they are overactivated by too much insulin, they begin to cause inflammation in the pancreas. Over time, this inflammation transforms acinar cells into precancerous cells, creating a pathway to cancer.
“This is a breakthrough in understanding how pancreatic cancer starts,” said Dr. Anni Zhang, the study’s first author. “Insulin doesn’t just control blood sugar—it also has powerful effects in the pancreas itself.”
The research shows that insulin receptors on acinar cells are central to this process. At normal levels, insulin helps the pancreas work properly. But in people with obesity and Type 2 diabetes, excess insulin puts these cells under constant pressure, promoting abnormal changes in tissue structure and triggering inflammation—a known risk factor for cancer.
The study’s findings open the door to new strategies for preventing pancreatic cancer. These could include lifestyle changes, medications that manage insulin levels, or even future treatments that target insulin receptors in the pancreas to block harmful effects while preserving insulin’s role in blood sugar control.
Dr. Janel Kopp, assistant professor at UBC and co-senior author of the study, emphasized that these findings could help guide clinical care. “We hope this research encourages lifestyle and medical interventions to keep insulin levels in a healthy range,” she said. “It may also lead to new therapies that slow or stop cancer development at its earliest stages.”
The team has already started a clinical trial with BC Cancer and the Pancreas Centre BC. This trial focuses on patients newly diagnosed with pancreatic cancer, helping them manage their insulin and blood sugar levels under the care of an endocrinologist.
The implications go beyond pancreatic cancer. Dr. Johnson noted that researchers in Toronto have identified similar insulin-driven processes in breast cancer. “We’re starting to see a bigger picture,” he said. “Elevated insulin may be a common factor in several obesity- and diabetes-related cancers.”
In the face of rising rates of obesity and diabetes worldwide, this study adds urgency to public health efforts aimed at preventing and managing these conditions—not only for heart and metabolic health, but also as a way to reduce the risk of deadly cancers like pancreatic cancer.
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The research findings can be found in Cell Metabolism.
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