Diabetes and Cancer: What’s the Connection?

Introduction

Yumlish’s core mission is to be a key nutrition and health education resource for managing and mitigating chronic health conditions like diabetes. April is National Cancer Control Month. Organizations across the US promote education campaigns to raise awareness about cancer prevention and support for those affected by cancer. 

This week, we honor National Cancer Control Month by discussing cancer risk in diabetic populations. 

The Diabetes Cancer Connection

There is a strong connection between diabetes and an increased risk of developing certain types of cancers, including pancreas, endometrium, colon/rectum, breast, and bladder cancers. This applies to both type 1 and type 2 diabetes. 

The principal factor contributing to the connection between diabetes and cancer involves hyperglycemia (high blood sugar levels). Hyperglycemia damages DNA and suppresses its repair mechanisms. This creates an environment conducive to cancer cell growth. Other factors like hyperinsulinemia, inflammation, oxidative stress, and advanced glycation end-products (AGEs) also play a role in increasing cancer risk in diabetics.

Certain demographics in the diabetic have a higher risk of developing cancer as well. Diabetic women have a 27% greater chance of developing cancer than non-diabetic women. Comparatively, diabetic men have a 19% higher risk than non-diabetic men.

Cancer Treatment for Diabetic Populations 

The treatment options for cancer in people with diabetes require careful consideration and a multidisciplinary approach involving oncologists, endocrinologists, and diabetes care teams. The following are some key points regarding cancer treatment, treatment risks, and prevention for diabetic patients:

  1. Chemotherapy. Chemotherapy drugs generally do not significantly increase blood sugar levels, but close monitoring and insulin therapy may be required. Steroids like dexamethasone, which are commonly given with chemotherapy, can cause insulin resistance and spike blood glucose levels. 
  2. Targeted Therapies. Some targeted cancer therapies like PI3K/AKT inhibitors, mTOR inhibitors, and insulin/IGF-1R inhibitors can worsen insulin resistance and impair insulin secretion, leading to hyperglycemia. These effects are usually reversible upon stopping the drug, however, glucose-lowering medications or insulin may be needed during treatment.
  3. Immunotherapies. Immune checkpoint inhibitors have been reported to cause autoimmune destruction of pancreatic beta cells in some cases, leading to fulminant diabetic ketoacidosis. Prompt recognition and insulin therapy are crucial for such cases.
  4. Glycemic Control. Tight glycemic control is not always the goal, especially for advanced cancers, to avoid depriving patients of potentially life-prolonging cancer treatments. However, extremely high blood sugar should be avoided to prevent dehydration, infections, and other symptoms.

While some cancer treatments can induce high blood sugar levels or suppress insulin production, increasing the risk of developing diabetes in cancer patients, certain diabetes treatments like metformin may have anti-cancer properties. This is because they reduce insulin levels and stimulate DNA repair, potentially lowering cancer risk.

Conclusion

It’s imperative to acknowledge the intersection between diabetes and cancer. The heightened risk faced by diabetic populations underscores the need for tailored approaches to cancer treatment and prevention.

Individuals with diabetes, or a known risk, may be more empowered to mitigate cancer risks and prioritize holistic health management through education and awareness. Diabetic patients should consult with their healthcare team to best understand their cancer risk and best treatment approach.

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