While the diabetes-promoting action of PDAC is explained by several studies as a paraneoplastic phenomenon caused by specific PDAC-secreted mediators (Sah et al., 2013; Batabyal et al., 2014; Javeed et al., 2015; Sagar et al., 2016; Andersen et al., 2017), our present findings provide an explanation for the PDAC-promoting action of diabetes, emphasizing the role of heparanase. Here, HPSE is linked to diabetes mellitus.