Cancer and diabetes are counted among the common diseases that have a huge impact on health around the world. It is also evident from various epidemiologic studies that these two diseases are interlinked. People with diabetes are found to have a higher risk for many types of cancer. It is considered to be one of the major risk factors for cancer.
Type 2 diabetes is known to associate with an enhanced risk of various cancers including liver, colon, breast, non-Hodgkins lymphoma, bladder, endometrial, and postmenopausal.
There is also some evidence regarding type 2 diabetes and a modest reduction in prostate cancer. However, it is not associated with a reduction of aggressive cancer forms. Also, the mortality rates of prostate cancer were found to be higher in men suffered from diabetes.
On the whole, enhanced cancer mortality and decrease survival rates are significantly associated with diabetes.
Let's explore how diabetes and changes associated with diabetes leads to cancer and diabetes management can help in cancer prevention:
Normal cells progressed into cancerous cells via three mechanisms:
• Initiation - Carcinogen or reactive molecule damages the DNA
• Promotion - Stimulation of cancerous cells' growth
• Progression - Further aggressive growth of cancerous cells along with angiogenesis and metastasis
Factors during diabetes which can lead to these changes can be:
Increased insulin and associated growth factors-
• According to the reports of various epidemiological studies, increased insulin levels are associated with enhanced postmenopausal breast, colorectal, pancreatic, endometrial, and bladder cancers.
• In the normal phase, insulin binds to its receptors and activates the metabolic pathways. This pathway initiates glucose uptake, glycogen synthesis, and suppresses fat breakdown and formation of glucose.
• However, in the abrupted insulin phase, the metabolic pathway gets blocked but cell proliferation doesn't stop. Also, enhanced insulin production to get over metabolic pathway blockage, the mitogenic pathway (pathway starts cell division) get more aggravated.
• The IGF-1 (insulin growth factor-1) was also found to be associated with estrogen receptor-positive breast cancer, prostate cancer, and colorectal cancer.
• Obesity and Type 2 diabetes both lead to chronic low-grade inflammation. This inflammation leads to generate free radicals which interrupt insulin production and mutations in DNA.
• This overall affects the normal growth of the cells, which becomes a major reason for cancer initiation.
• In females with hyperinsulinemia, the bioavailability of testosterone increases. This significantly relates to increased cancer risk.
• Also, in people with hyperinsulinemia, the production of sex hormone-binding globulin in the liver decreases. This increases the production of estrogen. Increase estrogen production is significantly associated with endometrial and breast cancer, especially in females who are not at hormone replacement therapy.
High Blood Sugar Levels-
• Diabetes leads to abruption high levels of blood sugar. This elevated blood sugar level is also associated with increased cancer risk.
• This leads to enhancing free radical production in the body, which leads to oxidative damage and mutation in genes targeting tumor and cancerous cells.
• Insulin resistance along with greater body fat leads to a potential increase in leptin production. Leptin is a hormone, which suppresses appetite and enhances energy expenditure.
• A rise in the levels of this hormone can increase hyperinsulinemia, inflammation, and estrogen production. All this together can make up a suitable environment for cancer growth.
Therefore people with diabetes need to take extra precautions and regular assessments and checkups for cancer prevention -
"Those who are obese, the American Diabetes Association (ADA) Standards of Medical Care in Diabetes suggests a 7 percent weight loss to lowers the risk of diabetes"
• Remember that even a loss of 2-8 kg can clinically benefit the obese and overweight person who is suffering from type 2 diabetes.
"American Institute for Cancer Research (AICR) recommends a waist circumference no major than 37 inches in males and 31.5 inches in females"
Other strategies for persons at higher risk of diabetes and cancer are -
• Eat non-starchy foods, while foods portions that are high in calories.
"Remember potato and legumes don't count toward the goal of having nonstarchy food items"
• Concentrate on eating fruits, vegetables, beans, and whole grains.
"A total of 2.5 cups of fruits and vegetables meet the daily requirements of ACS and AICR recommendations"
"Vegetables and fruits should not only consume in large amounts but also consume in variety. These involves foods rich in vitamin C, carotenoids, cruciferous vegetables, and allium vegetables"
• Avoid processed meat totally and limit the consumption of red meat.
"A meta-analysis results exhibited a 17% rise in the risk for colorectal cancer per 100 g of red meat consumed every day"
"Processed meats in form of smoking, salting, curing or preservatives found to be associated with an increase of risk for colorectal cancer"
"An 18% increase risk of this cancer has been seen for each 50 g consumption of processed meat every day"
AICR recommends not to have process meat and limit beef, pork, and lamb. The intake of these red meat forms should not be more than 18oz.
Substitute these meat dishes with varieties of legumes.
• Alcohol consumption should also be moderate amounts.
• It is noticed that in moderation the alcohol tends to reduce the risk of insulin resistance and hence type 2 diabetes.
• However, in excess, alcohol consumption significantly leads to enhance diabetes risk and colon cancer risk among males, pre-order, and postmenopausal females. It also tends to enhance the risk of throat, liver, and mouth cancers.
"According to ACS, consume alcohol only two days for males or one daily for females"
Regular exercise not only reduces your risk of diabetes but also improves cardiovascular health. It further also reduces your cancer risk, especially of colorectal cancer, postmenopausal breast cancer, and endometrial cancer.
"Recommendations for physical activity is at least 30 minutes of moderate activity daily, with potentially enhancing by advancing to 60 minutes moderate or 30 minutes vigorous activity every day"
Follow these recommendations and protect yourself from the risk of diabetes and step forward on the way to cancer prevention.