This may be a result of GLP-1 activating both EPAC1 and EPAC2 isoforms; whereas EPAC2 activation in response to GLP-1 stimulation is clearly linked to insulin secretion, EPAC1 activation may be linked to an increased risk of pancreatic disease, including pancreatic cancer. This evidence concerns the gene RAPGEF4 and familial pancreatic carcinoma.