How does diabetes affect cancer risk

Why diabetes increases the risk of cancer

In Germany, half a million people develop type 2 diabetes and another half a million people develop cancer every year. Numerous epidemiological studies show that there is a connection between the two common diseases. In 2018, a meta-analysis by Australian scientists found that male diabetics have a 19 percent higher risk of cancer than the general population, and female diabetics even a 27 percent higher risk of cancer. The German Cancer Research Center (DKFZ) and the National Center for Tumor Diseases (NCT) in Heidelberg prove this connection for colon cancer, especially for younger people.

Deadly quartet often precursors to diabetes

The question is why the metabolic disease diabetes has such a negative impact on the development of cancer. The Heidelberg scientists explain this connection with the metabolic syndrome that often precedes diabetes: excessive weight with a lot of abdominal fat, dysregulated blood lipids, increased blood pressure and increased blood sugar, often combined with insulin resistance, can derail the metabolism before diabetes is even diagnosed. The metabolic syndrome is also known as the fatal quartet.

Fat triggers inflammatory reactions and growth factors

"Belly fat is particularly dangerous when it comes to cancer," says DKFZ metabolism expert Mathias Heikenwälder. "Because this fatty tissue releases messenger substances into the environment that trigger inflammatory reactions and reduce the effect of insulin, so-called adiponectins and cytokines."

Some of these messenger substances also act as growth factors that stimulate other cells to divide and thus also promote tumor growth. The fat cells also produce estrogens. The hormones can stimulate cell growth in the breast and uterus. This is why overweight women are disproportionately affected by breast cancer or uterine cancer.

"If the metabolic syndrome has persisted for years, type 2 diabetes can develop; other common secondary diseases are arteriosclerosis, heart attacks, strokes - and cancer," says Heikenwälder.

Movement has a preventive effect

On the occasion of World Diabetes Day on November 14th, the Cancer Information Service at the DKFZ gives advice on how to reduce health risks. Its head, Susanne Weg-Remers, recommends an adjustment in lifestyle. "Diet and exercise are the levers that those affected have to use," she says. First of all, that means eating consciously and in a balanced way, with a balanced energy balance. Regular physical exercise, if possible 30 minutes a day, is just as important. "Exercise increases energy consumption and thus helps to reduce excess weight," says the doctor. "Those who take timely and consistent countermeasures can significantly reduce their personal risk of cancer and other serious secondary diseases of the metabolic syndrome."

Type 2 diabetes is on the rise worldwide: the WHO recorded a four-fold increase between 1980 and 2014 - from 108 million people at the time to 422 million. World Diabetes Day has been an official United Nations day of action since 2007. Since then, the day has been celebrated on November 14th every year - it is the birthday of Sir Frederick Banting, who discovered insulin together with Charles Best in 1922.

Photo: © Adobe Stock / Vadym

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