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Beeinflussen Diabetestherapien das Krebsrisiko?

Do antidiabetic therapies influence the risk for cancer?

  • Leitthema
  • Published:
Der Diabetologe Aims and scope

Zusammenfassung

In den letzten Jahren ist ein Zusammenhang zwischen Typ-2-Diabetes und der Inzidenz sowie der Mortalität verschiedener Krebserkrankungen gezeigt worden. Im Zentrum dieser Assoziation steht die Hyperinsulinämie, die direkt und indirekt Tumorwachstum und -entstehung fördert. Antidiabetische Therapien können diese Wirkung durch antiinsulinogene oder proinsulinogene Effekte reduzieren bzw. verstärken. In diesem Beitrag werden die zugrunde liegenden Wirkmechanismen beschrieben und die epidemiologische Evidenz für die aktuell verfügbaren Antidiabetika vorgestellt. Insbesondere Metformin kristallisiert sich nach bisherigem Kenntnisstand als vielversprechendes Therapeutikum heraus, das neben den bekannten antidiabetischen Wirkungen sowohl eine Reduktion des Krebsrisikos als auch der Mortalität bewirkt. Aktuell laufende prospektiv randomisierte Studien werden zeigen, inwieweit Metformin in Zukunft zu Prävention und Therapie von Krebserkrankungen eingesetzt werden kann. Erkenntnisse aus der Onkologie werden in die Diabetologie zurückwirken und das Indikationsspektrum von Metformin entsprechend erweitern.

Abstract

In recent years type 2 diabetes mellitus has been associated with increased cancer risk and mortality. Hyperinsulinemia is believed to be the central factor, promoting cancer incidence and progression by direct and indirect mechanisms. Antidiabetic therapies can either reduce or promote those effects by anti-insulinogenic or proinsulinogenic actions. In this article the pathophysiological mechanisms and current epidemiological evidence of available antidiabetic drugs will be reviewed. Metformin has received much attention as a promising drug that can reduce both cancer incidence and mortality. Prospective randomized trials are currently underway to evaluate the potential of metformin as a preventive and therapeutic drug in oncology. Depending on the outcome the antidiabetic profile of metformin will be complemented by its anticancer properties and expand the therapeutic spectrum of metformin use.

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  1. Klinik für Gastroenterologie, Stoffwechselerkrankungen und Internistische Intensivmedizin, Universitätsklinikum Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland

    J.M. Nagel

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Nagel, J. Beeinflussen Diabetestherapien das Krebsrisiko?. Diabetologe 8, 463–472 (2012). https://doi.org/10.1007/s11428-012-0865-6

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