Insulin Analogue Levemir and Development of Pancreatic Adenocarcinoma: A Case Report and Literature Review

There is an association between insulin analogues, glargine, lispro and aspart and the incidence of malignancies. A 76 year-old female patient with history of diabetes, hypertension and hyperlipidemia presented with flank pain after using insulin Levemir as part of her management. CT abdomen revealed pancreatic mass and endoscopic ultrasound- guided FNA aspiration biopsy showed pancreatic adenocarcinoma. It was not clear whether the insulin analogue initiated the tumor or helped the growth of pre-existing malignant foci. Then we concluded that case presented raises an indicator of possible association between using insulin analogue and initiation of malignancies, or stimulation of malignant foci.