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Association between diabetes and cancer. Current mechanistic insights into the association and future challenges

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Abstract

Compelling pieces of epidemiological, clinical, and experimental research have demonstrated that Diabetes mellitus (DM) is a major risk factor associated with increased cancer incidence and mortality in many human neoplasms. In the pathophysiology context of DM, many of the main classical actors are relevant elements that can fuel the different steps of the carcinogenesis process. Hyperglycemia, hyperinsulinemia, metabolic inflammation, and dyslipidemia are among the classic contributors to this association. Furthermore, new emerging actors have received particular attention in the last few years, and compelling data support that the microbiome, the epigenetic changes, the reticulum endoplasmic stress, and the increased glycolytic influx also play important roles in promoting the development of many cancer types. The arsenal of glucose-lowering therapeutic agents used for treating diabetes is wide and diverse, and a growing body of data raised during the last two decades has tried to clarify the contribution of therapeutic agents to this association. However, this research area remains controversial, because some anti-diabetic drugs are now considered as either promotors or protecting elements. In the present review, we intend to highlight the compelling epidemiological shreds of evidence that support this association, as well as the mechanistic contributions of many of these potential pathological mechanisms, some controversial points as well as future challenges.

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Authors and Affiliations

  1. Biomedical Research Labs, Medicine Faculty, Catholic University of Maule, Talca, Chile

    Armando Rojas & Ileana Gonzalez

  2. Medicine Faculty, Catholic University of Maule, Talca, Chile

    Ivan Schneider & Cristian Lindner

  3. Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, University of Chile, Santiago, Chile

    Miguel A. Morales

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  2. Ivan Schneider
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  3. Cristian Lindner
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All authors contributed to the original ideas and writing of this paper. Armando Rojas, designed the report and wrote the paper; Cristian Lindner art-work and data acquisition, drafting and revising the manuscript, Ivan Schneider, Ileana Gonzalez,and Miguel A. Morales, data acquisition, drafting and revising the manuscript.

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Rojas, A., Schneider, I., Lindner, C. et al. Association between diabetes and cancer. Current mechanistic insights into the association and future challenges. Mol Cell Biochem 478, 1743–1758 (2023). https://doi.org/10.1007/s11010-022-04630-x

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