In France, 52,491 patients were hospitalized in 2022 for uncontrolled diabetes or newly diagnosed diabetes (data from the French Health Care System). Many of these patients underwent a computed tomography (CT) abdominal scan to investigate potential pancreatic causes of poorly controlled diabetes. One possible cause of uncontrolled diabetes, whether in patients with newly diagnosed or uncontrolled diabetes mellitus, is pancreatic disease [1]. The most concerning condition, due to its poor prognosis, is pancreatic cancer (PC) [2]. The 5-year survival rate for all stages of pancreatic cancer is approximately 10 % [2,3]. This poor prognosis is partly explained by the difficulty in diagnosing the disease at an early stage, as symptoms are often nonspecific before clinical manifestation. These symptoms may include general deterioration, back pain, abdominal pain, depression, or even be completely absent [4]. Another contributing factor to this poor prognosis is that the only curative treatment currently available is surgery, which is feasible only in cases where the tumor remains localized (12.6-21.7 % of cases) [5]. Moreover, even when surgery is performed, the 5-year survival rate does not exceed 25 % [2]. Several risk factors for pancreatic cancer have been identified, including advanced age [6] (90 % of diagnoses occur in patients over 55 years old), cigarette smoking [7], alcohol use disorder [8], overweight and obesity [9], familial history of PC [6], genetic syndromes, ethnicity, diabetes [10] and pancreatic diseases such as pancreatitis and cysts [11]. Notably, pancreatic diseases can also lead to diabetes, a condition known as type 3c diabetes [1]. Uncontrolled diabetes is a common finding in patients with PC or pancreatic disorders, occurring in 30-50 % of patients newly diagnosed with PC [4]. There are currently no established guidelines regarding when a CT scan should be performed in patients admitted for uncontrolled diabetes to investigate potential pancreatic diseases. However, the probability of detecting PC in a patient with newly diagnosed diabetes is estimated to be less than 1 % [12]. Furthermore, both PC and uncontrolled diabetes often present with weight loss, making it difficult to distinguish patients who require imaging from those who do not. One potential approach could be to monitor patients to see if weight loss resolves when glycemic control is achieved. However, given the poor prognosis of PC, delaying diagnosis may not be advisable. Thus, the aim of our study was to assess the prevalence of pancreatic lesions in a population of patients hospitalized for newly diagnosed and/or uncontrolled diabetes and to identify potential predictive factors. Unlike previous larger studies conducted in outpatient settings or general population cohorts, our study focused specifically on a hospitalized population with uncontrolled or newly diagnosed diabetes—a clinical scenario in which pancreatic imaging is frequently considered but rarely standardized. This real-life approach reflects common diagnostic dilemmas faced by hospital-based physicians and aims to define pragmatic criteria for imaging.