Sweet Danger diabetes

Sweet Danger: How Diabetes Increases Cancer Risk

Don’t sugarcoat it: diabetes and cancer both requires attention ! Living with diabetes, particularly Type II, increases the likelihood of developing serious health complications beyond heart disease and kidney disease. Research reveals that individuals with diabetes are also more prone to certain types of cancer, including:

– Liver cancer

– Pancreatic cancer

– Colorectal cancer

– Endometrial cancer

– Breast cancer

– Bladder cancer

So let’s understand this relationship between diabetes and cancer, signs and symptoms, treatment and management so as to achieve the sweet victory over them.

WHAT IS DIABETES: UNCOVERING THE BASICS ?

Diabetes occurs when your body’s blood sugar levels become too high, disrupting the delicate balance of energy production. Normally, glucose from food and your body’s internal production is harnessed by insulin, a hormone produced by the pancreas, to fuel your cells. However, in diabetes, the body either fails to produce sufficient insulin or struggles to utilize it effectively. As a result, glucose accumulates in the bloodstream, depriving your cells of the energy they need. If left unmanaged, diabetes can lead to severe complications, including damage to vital organs like the eyes, kidneys, nerves, and heart, as well as increased risk of certain cancers. Fortunately, proactive measures can be taken to prevent or manage diabetes, reducing the likelihood of developing these associated health issues.

How to Lower Blood Sugar Naturally

Diabetes is categorized into two primary forms: Type 1 and Type 2. 

In Type 1 diabetes, the pancreas is unable to produce insulin, a crucial hormone for energy production. In contrast, Type 2 diabetes is characterized by the pancreas’s insufficient insulin production or the body’s inability to effectively utilize the insulin it produces, leading to insulin resistance. Notably, Type 2 diabetes is the more prevalent form, accounting for approximately 90% of all diabetes cases, with only a small percentage attributed to Type 1. 

THE PREVALENCE OF DIABETES: A GROWING CONCERN

Diabetes is a widespread health concern, affecting a significant portion of the population. The majority of the cases, ranging from 90% to 95%, are attributed to Type 2 diabetes. Globally, the prevalence of diabetes is staggering, with around 537 million adults currently affected. Alarmingly, this number is projected to escalate, reaching an estimated 643 million by 2030 and a staggering 783 million by 2045, according to expert forecasts. 

This infographics on the burden of diabetes in India is developed from the International Diabetes Federation Atlas highlighting the expected near doubling of prevalence of diabetes from 2019 to 2045.

WHY DO PEOPLE DEVELOP DIABETES? EXPLORING THE REASONS

In Type 1 diabetes, the body’s immune system mistakenly targets and destroys the pancreas’s beta cells, which are responsible for producing insulin. Researchers believe that a combination of genetic predisposition and environmental triggers, such as viral infections, may contribute to the development of Type 1 diabetes. Ongoing research initiatives, like the TrialNet study, aim to identify the precise causes of this autoimmune disease and explore potential strategies for prevention or slowing its progression. Type 2 diabetes, the predominant form of the disease, arises from a complex interplay of genetic and lifestyle influences. This multifaceted condition is shaped by a combination of inherited traits and acquired factors, such as dietary habits, physical activity levels, and other environmental elements.

Type2 Daibetes Mellitus

DIABETES SYMPTOMS: WHAT TO LOOK OUT FOR

When blood sugar levels become too high, the body is unable to harness the energy it needs, leading to a condition known as hyperglycemia. As a result, the body attempts to eliminate the excess sugar through increased urination. This can lead to a range of symptoms, including:

– Persistent fatigue and exhaustion

– Frequent urination, particularly during night time hours

– Excessive thirst and dryness

– Slow-healing cuts and wounds

– Genital itching or thrush infections

– Unintentional weight loss

– Blurred vision and impaired eyesight 

Recognizing these warning signs is crucial to addressing hyperglycemia and preventing potential complications.

symptoms of diabetes

IDENTIFYING DIABETES: SCREENING GUIDLINES AND TESTS

As it is recommended, screening for diabetes in individuals with risk factors, including:

– BMI over 25 (23 for Asian Americans) with additional risk factors like high blood pressure, abnormal cholesterol, physical inactivity, or family history

– Age over 35

– History of gestational diabetes

– Prediabetes diagnosis

– HIV diagnosis

Tests for Diabetes and Prediabetes:

  1. A1C Test: Measures average blood sugar levels over 2-3 months, with results indicating:

    – Diabetes: 6.5% or higher

    – Prediabetes: 5.7%-6.4%

    – Normal: Below 5.7%

  1. Random Blood Sugar Test: Measures blood sugar levels at any time, with results indicating:

    – Diabetes: 200 mg/dL or higher

  1. Fasting Blood Sugar Test: Measures blood sugar levels after overnight fasting, with results indicating:

    – Normal: Less than 100 mg/dL

    – Prediabetes: 100-125 mg/dL

    – Diabetes: 126 mg/dL or higher

  1. Glucose Tolerance Test: Measures blood sugar levels after consuming a sugary drink, with results indicating:

    – Normal: Less than 140 mg/dL

    – Prediabetes: 140-199 mg/dL

    – Diabetes: 200 mg/dL or higher

Additional Tests for Type 1 Diabetes:

– Urine test for ketones

– Autoantibody test for immune system cells associated with type 1 diabetes

Gestational Diabetes Screening:

– High-risk individuals: Tested at first prenatal visit

– Average-risk individuals: Tested during second trimester

CANCER: A COMPLEX AND MULTIFACETED DISEASE

Cancer encompasses a broad spectrum of disorders marked by uncontrolled cell growth, leading to the formation of abnormal cells that can invade and damage healthy tissues. One of the defining characteristics of cancer is its potential to metastasize, or spread, to other parts of the body. As the second-leading cause of mortality globally, cancer poses a significant threat to human health. However, advances in early detection, treatment, and prevention have contributed to improved survival rates for various types of cancer, offering new hope for those affected by this disease.

Cancer is a diverse group of diseases that can arise in any part of the body, with each type named according to its origin. For example, breast cancer remains classified as such even if it metastasizes to other areas. Cancers are broadly classified into two main categories: 1. Hematologic Cancers: These affect blood cells, encompassing leukemia, lymphoma, and multiple myeloma.

  1. Solid Tumor Cancers: These occur in organs or tissues, with common examples including breast, prostate, lung, and colorectal cancers.

While sharing some similarities, these cancers exhibit distinct characteristics in terms of growth, spread, and treatment response. Some cancers progress rapidly, while others grow more slowly. Certain types are more prone to metastasis, whereas others tend to remain localized. Treatment approaches vary, with some cancers responding well to surgery, others to chemotherapy, and often a combination of both yielding optimal results.

Cancerous cells multiplying and invading tissue, with normal cell and cancerous cell

UNDERSTANDING TUMORS: BENIGN VS. MALIGNANT

Tumors are abnormal growths that can be classified into two distinct categories: benign and malignant.

Benign Tumors:

– Typically grow slowly and do not invade surrounding tissues

– Do not metastasize (spread) to other parts of the body

– Usually do not cause symptoms unless they become large enough to compress nearby structures

– Are non-cancerous and typically treated with surgery, radiation, or medication if necessary

Malignant Tumors (Cancer):

– Can grow rapidly and uncontrollably

– Invade nearby tissues and potentially spread to distant areas through the bloodstream or lymphatic system (metastasis)

– Can cause varied symptoms depending on their location

– Require comprehensive treatment, including surgery, radiation, and chemotherapy, to manage and potentially eliminate the cancer.

tumor

For over a century, researchers have explored the potential link between diabetes and cancer. Studies have consistently shown that both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) are associated with an increased risk of developing cancer. In fact, cancer is the second leading cause of death among individuals with T1DM. Conversely, approximately 8-18% of cancer patients also have diabetes. Furthermore, previous research has indicated that diabetes is linked to a higher risk of cancer-related mortality. Despite these findings, the underlying mechanisms driving the relationship between diabetes and cancer remain unclear.

A substantial number of individuals are concurrently affected by both diabetes and cancer. Notably, those with type 2 diabetes, the most prevalent form, face an elevated risk of developing specific types of cancer. Research indicates that they are approximately twice as likely to develop liver or pancreatic cancer, and also exhibit an increased likelihood of developing colon, bladder, and breast cancer compared to the general population.

Research reveals a concerning disparity in cancer outcomes between women and men with diabetes. Women with both diabetes and breast cancer face a significantly higher mortality risk compared to those with breast cancer alone. In contrast, men with diabetes appear to have a surprisingly lower risk of developing prostate cancer, suggesting a potential protective effect. These findings highlight the importance of considering gender-specific factors in understanding the complex relationship between diabetes and cancer.

Ongoing research reveals a profound connection between cancer and diabetes, suggesting a shared underlying biology. Both diseases involve disruptions to the body’s metabolic processes, which may explain why obesity is a significant risk factor for both. Excess fat can trigger inflammation and release harmful chemicals, promoting tumor growth and insulin resistance, leading to type 2 diabetes. Furthermore, elevated insulin levels have been linked to cancer development, while cancer cells thrive on glucose, their primary fuel source. This complex interplay suggests a self-reinforcing cycle, where metabolic dysregulation fuels both diseases. Understanding this relationship is crucial for developing effective prevention and treatment strategies.

Studies have shown that cancer cells exhibit an extraordinary affinity for glucose, consuming it at a rate 200 times faster than normal cells. This phenomenon is leveraged in PET scans to detect cancer by identifying areas of elevated glucose uptake. Building on this insight, researchers are exploring the possibility of repurposing diabetes medications, such as metformin, to combat cancer by restricting glucose availability. Intriguingly, evidence suggests that diabetics taking metformin may have a lower incidence of cancer and, if diagnosed, a reduced risk of mortality. This promising connection has sparked intense interest among cancer researchers, who are investigating the potential of metformin as a adjunctive cancer therapy.

Diabetes and cancer. Diabetes-associated conditions, such as high glucose, oxidative stress, inflammation, angiogenesis, homocysteine, growth factor and low available glucose in cells, could be connected to cancer initiation and progression. In type 2 diabetes*, other factors, such as obesity, hyperinsulinemia, insulin resistance and high insulin-like growth factor (IGF)-1, might contribute to cancer initiation and progression.

THE COMPLEX INTERPLAY BETWEEN CANCER AND DIABETES: 

A BIDIRECTIONAL RISK

Research reveals a striking connection between cancer and diabetes, with each condition increasing the risk of developing the other. A 2018 JAMA Oncology study found that cancer patients are six times more likely to develop diabetes than the general population. This heightened risk may be attributed to cancer treatments rather than the disease itself. Radiation therapy can damage insulin-producing cells, while steroids used during chemotherapy can elevate blood sugar levels. The study showed that the risk of developing diabetes is greatest within two years of completing cancer treatment, but remains elevated thereafter. Furthermore, immunotherapies used to treat certain cancers may also contribute to the development of diabetes. Checkpoint inhibitors can trigger severe cases of diabetes by attacking insulin-producing cells in the pancreas, leading to type 1 diabetes. Additionally, pancreatic cancer patients are five times more likely to develop type 2 diabetes than their cancer-free counterparts. This bidirectional risk highlights the need for comprehensive care and monitoring for patients with either condition.

Pathways of the mutual relationship between diabetes and cancer. Several common factors are associated with a concomitant increase in the risks of diabetes and cancer. Additionally, the risk of cancer in diabetes is elevated through hyperinsulinemia and hyperglycemia. In contrast, patients with cancer are more susceptible to diabetes secondary to tumor‐related cytokines, sarcopenia, stress and steroid use.

HOW CANCER TREATMENT CAN IMPACT BLOOD SUGAR CONTROL

Certain cancer treatments, including radiation therapy, steroids, and some chemotherapy regimens, can significantly impact blood sugar levels. If left unmanaged, high blood sugar can lead to dehydration, a common side effect of chemotherapy, and potentially harm other organs. By prioritizing blood sugar control, you can:

– Stay hydrated and feel better during treatment

– Protect your organs from damage

– Maintain overall health and well-being

Regular monitoring of blood sugar levels is crucial to identify any changes and take prompt action. 

BALANCING ACT: NAVIGATING DIABETES MANAGEMENT DURING CANCER TREATMENT

Managing blood sugar levels can be a delicate balancing act, and cancer treatment can add an extra layer of complexity. Various factors, including medication, stress, illness, and dietary changes, can impact blood sugar control. If you’re taking insulin or diabetes medications, cancer treatment can make it even more challenging to maintain stable levels. To help you navigate this challenge, here are some valuable tips to keep your blood sugar levels in check during treatment:

HYPERGLYCEMIA

Certain steroids, like dexamethasone, can cause a spike in blood sugar levels. Symptoms during hyperglycemia (blood sugar above 11 mmol/L) are:

– Excessive thirst and fatigue

– Frequent urination

– Blurred vision

To manage hyperglycemia:

  1. Regularly monitor your blood sugar levels
  2. Consult your doctor about adjusting your diabetes medication or insulin
  3. Avoid reducing food intake to control blood sugar; instead, focus on balanced eating

In some cases, it is recommended to consume more carbohydrate-rich foods and drinks to help manage weight loss and support overall health. If you have concerns, don’t hesitate to reach out to your family physician.

HYPOGLYCEMIA:

If your blood sugar drops below 4 mmol/L, symptoms maybe:

– Shaky or trembling feelings

– Difficulty concentrating

– Sweating

– Confusion or disorientation

– Anxiety or nervousness

– Weakness or fatigue

– Hunger pangs

– Headache

– Nausea or dizziness

To address hypoglycemia:

  1. Consume a quick-acting carbohydrate:

    – Dissolve 3 teaspoons of sugar in water

    – Drink ¾ cup of juice (avoid citrus if you have a sore mouth or throat)

    – Have ¾ cup of regular pop

    – Take 1 Tablespoon of honey

    – Drink 1 cup of milk

    – Follow package directions for glucose tablets

  1. Recheck your blood sugar after 15 minutes
  2. If your blood sugar remains low, repeat steps 1 and 2
  3. Once your blood sugar returns to normal, consider having a small snack if your next meal or snack is more than 1-2 hours away

Remember to act promptly to manage hypoglycemia and prevent further complications.

EMPOWER YOUR REMISSION: TAKE CONTROL OF YOUR DIABETES, TAKE CONTROL OF YOUR CANCER RISK

Individuals with Type II diabetes face a higher likelihood of cancer diagnosis, but the exact link remains unclear. Is it the abnormal insulin levels or the accompanying health issues like obesity? One thing is certain: diabetes and cancer share common risk factors – obesity, inflammation, and elevated blood sugar.

The good news? By taking control of your diabetes, you can also lower your cancer risk and recurrence likelihood! 

Focus on:

– Nourishing your body: Fill two-thirds of your plate with vibrant vegetables, fruits, and whole grains, and limit red meat and processed foods.

– Moving with purpose: Aim for 150 minutes of moderate exercise or 75 minutes of vigorous activity weekly.

– Mindful indulgence: Limit alcohol intake, as excessive consumption damages cells and increases cancer risk. (Follow National Cancer Institute guidelines: one drink per day for women, two for men.)

– Blood sugar mastery: Prioritize controlling your blood sugar levels, before, during, and after cancer treatment.

CONQUERING THE DUAL CHALLENGE OF CANCER AND DIABETES: A CALL FOR COLLABORATIVE CARE

The intertwined complexities of cancer and diabetes demand a unified approach, bridging the expertise of oncologists and diabetologists. Effective management requires:

– Comprehensive screening before cancer treatment to assess diabetic complications, nutrition, and metabolic control

– Proactive management of treatment-induced hyperglycemia and consideration of therapy impacts on glucose metabolism

– Individualized treatment plans, close glucose monitoring, and adjusted antidiabetic therapy to minimize complications

The emerging field of diabeto-oncology prioritizes personalized strategies, biomarker identification, and primary prevention. By fostering collaboration, education, and awareness, healthcare providers can:

– Enhance clinical management

– Improve survival rates

– Elevate quality of life for patients navigating both cancer and diabetes

Together, we can conquer the dual challenge of cancer and diabetes, delivering holistic care that addresses the unique needs of this patient population.

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