Type 2 diabetes and cancer: further evidence for treating one to prevent the other

Type 2 diabetes is a chronic condition whose prevalence has increased drastically in the past few decades, an increase which is largely attributed to an increase in levels of obesity.

It’s thought that 4 million deaths a year are related to this disease, the majority of which are due to cardiovascular complications. Recently though, cancer has also emerged as an important comorbidity to diabetes, and so appropriate diabetes control now has a key role to play in reducing the cancer burden.

It looks like at least part of the reason for this link between diabetes and cancer is hyperglycemia (high blood sugar level). There are several pathways by which it can cause an increased risk of cancer. One of the causes of hyperglycemia is improper control of diabetes, so logically, it follows that controlling diabetes can also reduce the risk of cancer.

Of course, there are lots of other potential links between diabetes and cancer. They share many common risk factors, such as older age, obesity, poor diet, and physical inactivity, all of which are increasing due to globalization and modernization. Reducing the modifiable risk factors, by way of pharmacological therapy or lifestyle changes, may help to reduce the risk of both cancer and diabetes.

Coming back to hyperglycemia, previous studies have separately shown that controlling blood sugar levels, or using renin-angiotensin system (RAS) inhibitors, or using statins, is associated with a reduced cancer risk.

DiabetesIn a research article published in BMC Medicine, Prof Alice Kong and colleagues at the Chinese University of Hong Kong added to these previous studies by looking at whether controlling blood sugar levels and using RAS inhibitors and statins together could additively help to reduce risk of cancer.

Using a large and well-characterized registry of over 6000 patients with type 2 diabetes, they concluded that hyperglycemia may promote cancer growth, which could be attenuated by controlling blood sugar levels, and use of RAS inhibitors and statins.

These findings underscore the importance of adherence to medication, which can aid control of both the primary disease for which the drug would have been prescribed, such as  diabetes, hypertension and hypercholesteremia, and also the potential comorbidities. This is perhaps of particular importance in Asia, where diabetes prevalence has become acute.

The results further demonstrate the complex nature of the cross-talk between diabetes and cancer, and also add to the ongoing debate about statins and how beneficial they are, which you can read more about in one of our previous blog posts.

Clearly, better understanding of the interactions between diabetes and cancer should help researchers and clinicians identify opportunities for preventing diabetic comorbidities, while improved control of diabetes could lead to substantial reductions in the burden of disease.

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