The risk of numerous illnesses, including different types of cancer, is elevated in individuals with type 2 diabetes mellitus; however, the exact mechanisms behind this link are yet unknown.
A recent investigation into the likelihood of developing cancer in diabetics was published in the journal BMC Medicine.
A metabolic condition known as type 2 diabetes mellitus is brought on by a combination of environmental and hereditary factors. Numerous large epidemiological studies have shown that people with diabetes have an increased chance of developing malignancies of the bladder, breast, colon, rectum, pancreas, liver, and uterine.
Diabetes is linked to microvascular illness, of which diabetic retinopathy (DR) is the most prevalent form. DR is the leading cause of middle-aged vision loss. High blood sugar, high amounts of toxic advanced glycation end products, and the activation of many pathways that are also linked to the development of malignancies are some of the variables that contribute to diabetes-related memory loss (DR).
Cancers and DR also have common characteristics such as oxidative stress, inflammation, vascular abnormalities, and the creation of new blood vessels. Therefore, improved glycemic management may lower the incidence of cancer in this population.
Data from the Taiwan Cancer Registry (TCR), the National Death Registry (NDR), and the National Health Insurance Research Database (NHIRD) were analyzed for the current retrospective analysis between January 1, 2007, and December 31, 2018.
Initially, the groups with and without primary diabetes were made up of data from 3,111,975 and 22,208,395 patients, respectively. The study excluded patients who had been diagnosed with cancer before being diagnosed with diabetes, patients whose diabetes was brought on by conditions that could also independently cause cancer, such as viral infections like hepatitis B or C, and patients who were twenty years of age or younger. As a result, there were 1,751,457 patients overall in the categories with and without diabetes.
In addition, the existence of DR, which indicates the length of diabetes and the level of glycemic control, was used to stratify diabetes patients. Proliferative (PDR) and non-proliferative (NPDR) DR was another classification for the disease. Patients with diabetes had a 20% increase in the overall incidence of cancer. The biggest risk increase was seen for cancers of the liver and pancreas, which were followed by malignancies of the mouth, gallbladder, female reproductive system, kidney, and brain. The risk increase was found to be between 25 and 34%, with the exception of kidney malignancies, where the risk was 44% higher.
Cancers of the stomach, skin, breast, and urinary system in women were among the other cancers whose risks were moderately elevated by 17–20%. Esophageal cancer was the only malignancy to decrease in the diabetes cohort. Male patients with diabetes had a 20% higher risk of developing cancer. Individuals who also had hypertension were 10% more likely to develop cancer, whereas people with high blood lipid levels had a 14% lower risk of developing cancer overall but a higher risk of developing breast cancer in women.
Elevated risk of cardiovascular death may be the cause of the inverse relationship between hyperlipidemia and cancer; nevertheless, elevated cholesterol levels may also directly prevent cancer.
DR patients with diabetes had a total cancer incidence of 32%, which was considerably higher than the cancer incidence in the non-DR cohort (20%). The diabetes with DR cohort showed a rise in cancer incidence in the liver, mesothelium, urinary tract, and soft tissues. The colon, stomach, lips, pancreas, and oral cavity were among the other areas having a somewhat elevated risk of cancer. Patients with diabetes and DR also had higher rates of lymphatic and bone marrow cancers.
PDR patients had a 13% higher risk than NPDR patients among those with DR. individuals with PDR had higher rates of stomach, liver, female organ, and urinary tract malignancies than individuals with NPDR. In a similar vein, men were 25% more vulnerable than women.
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