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Hyperglycemia as a Risk Factor for Cancer Progression
Tae Young Ryu, Jiyoung Park, Philipp E. Scherer
Diabetes Metab J. 2014;38(5):330-336.   Published online October 17, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.5.330
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AbstractAbstract PDFPubReader   

As the prevalence of diabetes mellitus is substantially increasing worldwide, associated diseases such as renal failure, cardiovascular diseases, fatty liver, and cancers have also increased. A number of cancers such as pancreatic, liver, breast, and female reproductive cancers have shown an increased prevalence and a higher mortality rate in diabetic patients compared to healthy subjects. Thus, this suggests an association between diabetes, especially type 2 diabetes and cancer incidence and progression. Recent studies have suggested that hyperinsulinemia, chronic inflammation and hyperglycemia, all frequently seen in diabetics, may lead to increased tumor growth; the underlying molecular mechanisms of this association are not fully understood. In particular, chronic hyperglycemic episodes could serve as a direct or indirect mediator of the increase in tumor cell growth. Here, we will discuss our current understanding how hyperglycemia and cancer risk may be linked, and what the implications are for the treatment of diabetic cancer patients.

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Diabetes and Cancer: Is Diabetes Causally Related to Cancer?
Sunghwan Suh, Kwang-Won Kim
Diabetes Metab J. 2011;35(3):193-198.   Published online June 30, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.3.193
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AbstractAbstract PDFPubReader   

Diabetes mellitus is a serious and growing health problem worldwide and is associated with severe acute and chronic complications. Moreover, epidemiologic evidence suggests that people with diabetes are at significantly higher risk for many forms of cancer. Several studies indicate an association between diabetes and the risk of liver, pancreas, endometrium, colon/rectum, breast, and bladder cancer. Mortality is also moderately increased in subjects with diabetes. Common risk factors such as age, obesity, physical inactivity and smoking may contribute to increased cancer risk in diabetic patients. Hyperinsulinemia most likely favors cancer in diabetic patients as insulin is a growth factor with pre-eminent metabolic as well as mitogenic effects, and its action in malignant cells is favored by mechanisms acting at both the receptor and post-receptor level. The effect of diabetes treatment drugs, aside from metformin, on cancer is not conclusive. In order to fight the perfect storm of diabetes and cancer, strategies to promote primary prevention and early detection of these conditions are urgently needed.

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Original Article
Prevalence of Diabetes Mellitus in Pancreatic Cancer Patients.
Yu Jeong Park, Kwang Won Kim, Eun Young Oh, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Jong Kyun Lee, Kyu Taek Lee, Yong Il Kim, Yoon Ho Choi
Korean Diabetes J. 2001;25(4):316-322.   Published online August 1, 2001
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AbstractAbstract PDF
BACKGROUND
Pancreatic cancer is a highly malignant tumor and its incidence has been significantly increased. It has well been known that pancreatic cancer patients had high prevalence of diabetes mellitus. But it is still controversial if diabetes predispose pancreatic cancer or it is an epiphenomenon of pancreatic cancer. Thus, the aims of this study was to investigate the prevalence of diabetes mellitus in pancreatic cancer patients in Korea, to characterize the diabetes mellitus in this situation, and to observe an association between the two conditions. METHOD: 275 pancreatic cancer patients admitted in Samsung Medical Center from January 1998 to December 2000 were selected for this study. We reviewed patients medical record and recorded diabetic history. Subjects who visited our Health Promotion Center in 1999 was used to evaluate the prevalence of diabetes mellitus. RESULT: 30% of pancreatic cancer patients had diabetes mellitus. 60% of diabetic pancreatic cancer patients had detected diabetes within recent two years. 25.6% of them had been known their diabetic state when they detected pancreatic cancer. There were no differences in smoking history, percent of distant metastasis, frequency of curative resection, and BMI between diabetic and nondiabetic pancreatic cancer patients. Significant weight loss was noted in pancreatic cancer patients with diabetes (p<0.01). CONCLUSION: The prevalence rate of diabetes in pancreatic cancer patient was significantly high. Pancreatic cancer patients with diabetes presented with much profound weight loss. Furthermore, more than half of the pancreatic cancer patients with diabetes had recent onset diabetes. Further investigations would be necessary to elucidate causal relation in the pathogenesis of diabetes and pancreatic cancer.

Diabetes Metab J : Diabetes & Metabolism Journal
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