INS and Insulin resistance: Inflammatory factors such as TNF-α and IL-1β not only play a role in the occurrence and progression of pancreatitis,372 but also contribute to the development of diabetes by inducing apoptosis and dysfunction of islet cells.357 For example, IL-1β increases the risk of diabetes by interacting with insulin signaling pathways, resulting in insulin resistance.373 In addition, the persistent inflammatory environment caused by chronic pancreatitis can activate oncogene and tumor suppressor gene mutations, thereby promoting the development of PDAC.374