Type 2 Diabetes Mellitus and Cancer: Epidemiology, Physiopathology and Prevention

Abstract

Individuals with type 2 diabetes mellitus are at greater risk of developing cancer and of dying from it. Both diseases are age-related, contributing to the impact of population aging on the long-term sustainability of health care systems in European Union countries. The purpose of this narrative review was to describe, from epidemiological, pathophysiological and preventive perspectives, the links between type 2 diabetes mellitus and the most prevalent cancers in these patients. Multiple metabolic abnormalities that may occur in type 2 diabetes mellitus, particularly obesity, could explain the increased cancer risk. In addition, the effectiveness of drugs commonly used to treat type 2 diabetes mellitus (e.g., metformin and thiazolidinediones) has been broadly evaluated in cancer prevention. Thus, a better understanding of the links between type 2 diabetes mellitus and cancer will help to identify the contributing factors and the pathophysiological pathways and to design personalized preventive strategies. The final goal is to facilitate healthy aging and the prevention of cancer and other diseases related with type 2 diabetes mellitus, which are among the main sources of disability and death in the European Union and worldwide.

Type 2 Diabetes Mellitus and COVID-19: A Narrative Review

“…As discussed above, inflammatory exacerbation due to increased cytokines levels has been recognized as one of the main keys to poor prognosis in COVID-19. The anti-inflammatory properties of metformin are already known, suggesting a beneficial effect for COVID-19 disease [ 52 ]. Despite this, immunomodulatory actions of metformin in the context of COVID-19 remain unclear.…”

Metformin: A Narrative Review of Its Potential Benefits for Cardiovascular Disease, Cancer and Dementia

“…After adjustment the hazard ratio was 0.63 (95% CI 0.53, 0.75) [ 78 ]. An overview of studies with metformin performed in the last 5 years showed a possible protective effect in the incidence of colorectal, hepatic, head and neck and lung cancers [ 79 ].…”

Diabetes mellitus in relation to colorectal tumor molecular subtypes: A pooled analysis of more than 9000 cases

“…4 This connection is likely independent of shared risk factors between diabetes and colorectal cancer. 5 Instead, the association between diabetes and colorectal cancer may depend on other mechanisms such as alterations to the gut microbiome, increased inflammation in the gut, hyperinsulinemia in early stage type 2 diabetes and activation of cancer promoting pathways. 6 Colorectal cancer is a heterogeneous disease, displaying considerable differences in molecular markers, which correlate with anatomical tumor location and other clinical and patient characteristics.…”

“…Individuals with diabetes mellitus, especially those with type 2 diabetes, have an increased risk of developing colorectal cancer 4 . This connection is likely independent of shared risk factors between diabetes and colorectal cancer 5 . Instead, the association between diabetes and colorectal cancer may depend on other mechanisms such as alterations to the gut microbiome, increased inflammation in the gut, hyperinsulinemia in early stage type 2 diabetes and activation of cancer promoting pathways 6 …”