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There is a complex connection between diabetes mellitus and pancreatic carcinoma, whereby it has been a target of many studies. The new-onset diabetes may be a symptom caused by occult pancreatic cancer, but the most important question remains when to think about it. We present a case report of a 72-year-old female with a new-onset diabetes mellitus, initially diagnosed with no associated complications. However, a few months later, glycemic index was uncontrolled despite optimized therapy. It led to further study and a pancreatic carcinoma was discovered. With this case we intend to raise awareness that new-onset diabetes could be a hint for a hidden disease, especially when glycemic index is difficult to control despite optimized therapy. For that reason, physicians must be aware of the intrinsic relationship between diabetes and pancreatic carcinoma.