Diabetes type 2: Dr Zoe Williams discusses high blood sugar risks

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There was a recent collaboration between the London School of Hygiene and Tropical Medicine and the University of Leicester. Together, the research teams analysed years of interesting data from 1998 to 2018, which was published on January 24, 2023. Lead author Dr Suping Ling said: “Our findings underline the growing cancer burden in people with type 2 diabetes, particularly in older individuals.”

Dr Ling stated the research “highlight[s] the need to prioritise cancer prevention, research, and early detection and management”.

Most notably, Dr Ling said an emphasis should be on liver, pancreatic, and endometrial cancer in diabetic patients.

Looking at 137,804 individuals aged 35 and over with newly diagnosed type 2 diabetes, the patients typically had an average follow-up of eight years later.

Trends in all-cause, all-cancer, and cancer-specific mortality rates were analysed by age, gender, ethnicity, socioeconomic status, obesity and smoking status.

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Researchers have pondered why their results show that diabetics are at higher risk of certain cancers than the general population.

In this case, the researchers think it could be due to the effects of increased blood sugar and insulin levels, insulin resistance, and chronic inflammation.

Moreover, despite national reports showing a decrease in breast cancer mortality in the younger age ranges, this new research suggests otherwise for young diabetic women.

Dr Ling explained: “Our results suggest that it may be helpful to extend breast cancer screening to young women with type 2 diabetes.”

Yet, Dr Ling recognises the practicality issues with doing so, such as the “high cost”.

He said: “Cost-effectiveness analyses are required to define the appropriate time window and identify subgroups who may benefit more.”

Dr Ling added: “The prevention of cardiovascular disease has been, and is still considered, a priority in people with diabetes.

“Our results challenge this view by showing that cancer may have overtaken cardiovascular disease as a leading cause of death in people with type 2 diabetes.

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“Cancer prevention strategies therefore deserve at least a similar level of attention as cardiovascular disease prevention.”

Dr Ling said this should be so, “particularly in older people and for some cancers such as liver, colorectal and pancreatic cancer”.

Diabetics who smoke are at even greater risk of developing cancer during their lifetime.

Dr Ling said: “Tailored interventions should also be considered for smokers, who had higher and steadily increasing cancer mortality rates.”

Dr Ling concluded that for people with type 2 diabetes, there should be “early cancer detection through changes to existing screening programmes”.

He also promotes “more in-depth investigations for suspected or non-specific cancer symptoms”, which “may reduce the number of avoidable cancer deaths”.

Diabetics who struggle to effectively manage their blood sugar levels should seek support from their healthcare team.

The research paper can be seen in the journal Diabetologia.

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