Alongside the various causes of β cell impairment and decreased numbers mentioned above, epidemiological, and clinical studies suggest that PDAC-DM is possibly a paraneoplastic phenomenon mediated by DM-causing substances.301 Insulin resistance has been implicated in the pathogenesis of PDAC-DM, which is present in patients with PDAC (normal fasting glucose levels) and disappears after surgical resection.301 Islet amyloid polypeptide (IAPP) is believed to be involved in this process. The gene discussed is IAPP; the disease is diabetes mellitus.