Diabetes, Insulin Resistance, and Cancer: An Update
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- de Miguel-Yanes, J.M. Curr Cardio Risk Rep (2011) 5: 70. doi:10.1007/s12170-010-0136-2
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There is evidence supporting that type 2 diabetes, either per se or through the concurrence of other factors and chronic conditions like obesity, confers a higher risk for some types of cancer. Association between type 1 diabetes and cancer seems to be weaker. It is a plausible hypothesis that some diabetes treatments modify the cancer risk that diabetes poses. The in vitro mitogenic properties of the insulin analogs have long been known. Metformin activates the AMP-activated protein kinase, thus interfering with metabolism of cancer cells. Randomized controlled trials including very large numbers of cases would be needed to definitely prove or discard these drugs specific cancer associations. In their absence, evidence comes from epidemiologic observational studies, which must include appropriate adjustments for confounding factors to avoid biases and misleading conclusions. This article presents an update of the last research on pathophysiology and on the association between diabetes and its treatments with cancer.