A study indicated an increased risk of PDAC associated with elevated fasting blood glucose levels.433 High blood glucose induces the activation of p38 MAPK, mediating the paracrine secretion of IL-6 and VEGF, thereby promoting the proliferation and migration of PDAC cells.433 Glucose dosage dependently increases the expression of glial cell line-derived neurotrophic factor (GDNF) and its tyrosine kinase receptor (RET), promoting the growth of PDAC cells.434 Prolonged hyperglycemia leads to the accumulation of advanced glycation end products (AGE). Here, GDNF is linked to Hyperglycemia.