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Diabetes mellitus and cancer
1Department of Gastroenterology and Metabolic Diseases, Central Clinical Hospital, University Medical School of Warsaw, ul. Banacha 1A, PL-02-097, Warsaw, Poland
European Journal of Internal Medicine
|October 12, 2000
Summary
Diabetes, particularly type 2, is linked to increased cancer risk, especially liver and pancreatic cancers. Managing blood sugar and insulin levels may help reduce this risk.
Area of Science:
- Endocrinology
- Oncology
- Epidemiology
Background:
- An association between diabetes and cancer has been recognized for over a century.
- Modern epidemiological studies confirm an elevated cancer risk in diabetic patients, predominantly those with type 2 diabetes.
- The specific cancer sites affected include liver, pancreas, colorectum, endometrium, breast, and kidney.
Purpose of the Study:
- To review the evidence linking diabetes and cancer risk.
- To explore potential mechanisms, such as hyperinsulinemia, underlying this association.
- To discuss implications for managing type 2 diabetes.
Main Methods:
- Review of prospective epidemiological cohort and case-control studies.
- Analysis of cancer risk variations by tumor site.
- Examination of etiological hypotheses, focusing on insulin's role.
Main Results:
- Type 2 diabetes is associated with increased risk for several cancers.
- The risk is highest for primary liver cancer, followed by pancreatic cancer.
- Moderate to low increases in risk are observed for colorectal, endometrial, breast, and renal cancers.
Conclusions:
- Hyperinsulinemia, resulting from insulin resistance in type 2 diabetes, is a leading hypothesis for increased cancer risk due to its potential mitogenic effects.
- Further prospective studies are needed to confirm the role of insulin.
- Therapeutic strategies for type 2 diabetes should aim for optimal metabolic control and reduced hyperinsulinemia, potentially involving lifestyle changes and medications like metformin or acarbose.