Association of Diabetes Mellitus and Alcohol Abuse with Cancer: Molecular Mechanisms and Clinical Significance

Abstract

Diabetes mellitus (DM), one of the metabolic diseases which is characterized by sustained hyperglycemia, is a life-threatening disease. The global prevalence of DM is on the rise, mainly in low- and middle-income countries. Diabetes is a major cause of blindness, heart attacks, kidney failure, stroke, and lower limb amputation. Type 2 diabetes mellitus (T2DM) is a form of diabetes that is characterized by high blood sugar and insulin resistance. T2DM can be prevented or delayed by a healthy diet, regular physical activity, maintaining normal body weight, and avoiding alcohol and tobacco use. Ethanol and its metabolites can cause differentiation defects in stem cells and promote inflammatory injury and carcinogenesis in several tissues. Recent studies have suggested that diabetes can be treated, and its consequences can be avoided or delayed with proper management. DM has a greater risk for several cancers, such as breast, colorectal, endometrial, pancreatic, gallbladder, renal, and liver cancer. The incidence of cancer is significantly higher in patients with DM than in those without DM. In addition to DM, alcohol abuse is also a risk factor for many cancers. We present a review of the recent studies investigating the association of both DM and alcohol abuse with cancer incidence.

High risk of non-cancer mortality in bladder cancer patients: evidence from SEER-Medicaid

“…The relationship between BC and diabetes mellitus should not be underestimated. Patients with a long history of impaired fasting glucose or diabetes mellitus are at significantly higher risk of BC due to diet, obesity and other factors (Choi et al 2022 ; Lam et al 2021 ; Gill et al 2021 ). A meta-analysis suggests that diabetes mellitus has an increased risk of disease progression, recurrence and death in BC patients (Lu and Tao 2021 ).…”

TFPI2 suppresses the interaction of TGF-β2 pathway regulators to promote endothelial–mesenchymal transition in diabetic nephropathy

“…Diabetes is a global health problem and causes multiple comorbidities (such as liver disease and cancer) and complications (such as diabetic foot, heart attack, and DN) 39,40 . Currently, DN is the worldwide common cause of end-stage renal disease that requires kidney replacement 41 .…”

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“…Adequate blood sugar control is beneficial in reducing the risk of malignant tumors. Obese patients with type 2 diabetes have a higher risk of developing cancer such as liver ( 44 ), biliary tract ( 45 ), pancreatic ( 46 ), colorectal ( 47 ), kidney ( 48 ), bladder ( 49 ), breast ( 50 ) and endometrial cancer ( 51 ). Insulin resistance leads to unsatisfactory treatment effects in diabetes, and is a chronic, non-specific inflammatory process.…”