Serum CA19-9 measured in two independent diagnostic cohorts. In training (a) and validation (b) (Sets 2 and 3) serum CA19-9 levels were significantly elevated in PDAC, regardless of DM status, compared to all other controls (p<0.0001). No difference in CA19-9 level was observed between PDAC-DM and PDAC. In non-cancer controls, CA19-9 was significantly elevated in LSDM compared to healthy controls (p=0.03 and p=0.001 in Sets 2 and 3, respectively), however, no significant upregulation was observed between NOD and HC. For a and b, the median and interquartile range are shown for each group. PDAC, pancreatic cancer; PDAC-DM, pancreatic cancer-related diabetes; CP, chronic pancreatitis; CP-DM, chronic pancreatitis-related diabetes; LSDM, long-standing diabetes (>3yr post-diagnosis of DM); NOD, new-onset diabetes (<3yr post-diagnosis of DM).