Reducing Your Risk of Cancer With Type 2 Diabetes
By Patrick Sullivan
There is evidence suggesting a link between type 2 diabetes and certain cancers. Here’s what you can do that may help reduce your risk.
If you have diabetes, you know how important it is to take an active role in your health: monitoring glucose, making time for exercise, and watching what you eat.
Not only can diabetes be dangerous if left untreated, but type 2 diabetes can also raise your risk for a host of other health problems, including heart disease, kidney damage, and other complications. But does diabetes increase cancer risk?
How exactly type 2 diabetes might contribute to cancer is still a mystery. However, experts suggest it could have to do with factors like aging, obesity, increased insulin levels, insulin resistance, inflammation, and hyperglycemia (high blood sugar).
The good news is that managing your health means you may also be cutting your cancer risk.
“Keeping your diabetes under control is the best way of trying to prevent cancer down the road,” said Dr. Amanda Leiter, an endocrinologist and cancer researcher at Mount Sinai Hospital in New York.
Here’s more about the link between type 2 diabetes and certain cancers, plus proactive steps you can take to reduce your risk.
Does diabetes cause cancer?
“There have been pretty rigorously done studies that show associations between diabetes and certain types of cancer,” said Leiter.
According to a review of studies on type 2 diabetes and 20 types of cancer, the evidence is strongest for an association between diabetes and these cancers:
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Breast cancer
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Colorectal cancer
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Endometrial cancer
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Liver cancer
A 2021 review of studies further lists gallbladder and pancreatic cancers as being strongly linked with diabetes. That said, an association does not mean that type 2 diabetes causes cancer; there are likely shared risk factors between the two diseases, such as aging, obesity, diet, and physical inactivity.
Diabetes is also loosely linked to other cancers, including:
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Oral cancer
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Ovarian cancer
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Bladder cancer
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Kidney cancer
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Thyroid cancer
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Myeloma (a type of blood cancer)
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Leukemia
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Glioma (brain and spinal cord tumor)
The cancer-diabetes connection
Researchers suggest it’s possible that type 2 diabetes contributes to cancer risk via several pathways.
Hyperglycemia
High blood sugar is a hallmark of diabetes. Research indicates it could increase the risk of cancer in a number of ways. High glucose levels damage and alter DNA. Hyperglycemia may also promote the buildup of cancer-causing compounds, which may make malignant cell mutations more likely.
Since cancer cells divide so rapidly and resist death, they’re particularly hungry for glucose. Cancer cells are also able to process blood sugar better. This is called the Warburg Effect, named after scientist Otto Warburg, who first observed the effect in the 1920s.
“Essentially, it means that cancer cells thrive,” said Leiter. “They can use glucose regardless of the environment they’re in to proliferate and grow.”
Insulin resistance
Another potential risk factor for cancer is high insulin levels and insulin resistance.
“Increased insulin levels promote cancer growth because there are certain cancer types that have insulin receptors,” said Leiter.
Insulin also encourages your liver to produce more of a hormone that regulates cell division and death. One study found that while insulin may directly contribute to an increased risk of cancer, many of the ways it encourages cell growth and discourages cell death (both of which allow tumors to grow unchecked) are actually the result of other hormones.
Inflammation
Inflammation – your immune system’s chemical response to injury or illness – is a well-known risk factor for developing cancer. It’s also an integral part of type 2 diabetes and is associated with diabetes complications, such as retinopathy and neuropathy.
Inflammation is not so much an independent factor that increases cancer risk, but is associated with hyperglycemia and high insulin levels (both of which may cause chronic inflammation). Similarly, obesity – another risk factor common in people with type 2 diabetes – is linked to constant, low-grade inflammation.
How to reduce cancer risk with type 2 diabetes
Steps you take to manage your diabetes also work to cut your risk of cancer, said Leiter. If you have cancer, it also gives your treatment a better chance to work.
“A healthy lifestyle, in general, will help diabetes and also helps prevent cancer,” she said. “And not just because it’s keeping diabetes under control. We know a healthy diet and exercise helps prevent cancer even on their own.”
Here are a few steps you can take.
Cancer screenings
Leiter stresses the importance of following recommended cancer screening guidelines, especially for the types that may be associated with diabetes. She points to the progress made on diabetes and heart disease and suggests a reduction of cancer deaths in people with diabetes is possible.
Diet
Managing your diet when you’re going through cancer treatment can be especially tricky. Loss of appetite and loss of weight and muscle mass (cachexia) are both symptoms of cancer and some forms of cancer treatment.
Leiter recommends eating dense, nutrient-rich foods with a good mix of protein, healthy fats, and simple carbs, including fiber. She also suggests taking advantage of the resources at a local cancer treatment center.
“A lot of cancer centers have nutritionists specifically to help deal with this,” she said.
Exercise
Getting enough movement and exercise throughout the day is just as important as what you eat. That said, this can be especially challenging if you have diabetes and cancer.
“Exercise is really hard to do during cancer treatment,” said Leiter. “There’s a lot of treatment-related fatigue, and treatment is just really tough on the body.”
Every little bit of extra movement helps, though.
“Study after study shows that any bit of activity or movement helps with symptom management in cancer treatment and also helps with overall prognosis,” said Leiter. “So any bit of activity, even if it’s just a short walk, can help you feel better and help with your treatment course.”
Not only does diabetes share a number of risk factors with some types of cancer, but it also shares many of the same disease pathways like hyperglycemia, insulin resistance, and inflammation. By controlling your diabetes and making healthy choices each day, you can work towards reducing diabetes symptoms and complications while cutting your cancer risk.
