A recent study published in Molecular Aspects of Medicine reviews the mechanisms that may be responsible for the relationship between type 2 diabetes mellitus (T2DM) and endometrial cancer (EC).
Individuals with T2DM are at a greater risk of developing reproductive cancers, including EC, breast cancer and ovarian cancer. Many studies have explored this link, attributing it to a wide variety of disease processes.
Studies have shown that individuals with T2DM have a 72% higher risk of developing EC than those without T2DM. These patients tend to have poorer outcomes, with worse survival, increased rates of recurrence and more aggressive tumors.
Patients with T2DM experience changes in the structure of the endometrial tissue and experience an altered ability to respond to hormonal signals. High blood sugar may also provide the cells with a large supply of glucose, which promotes cell growth.
Read more about EC causes and risk factors
EC is associated with disruptions in estrogen and progesterone levels in the bodies of patients with T2DM. Chronic hyperinsulinemia, or high levels of insulin, may raise levels of estrogen and insulin-like growth factors. Individuals who do not ovulate regularly due to insulin resistance may overproduce estrogen, which can contribute to malignancy.
Furthermore, patients with T2DM experience systemic inflammation, which is a risk factor for several cancers. Pro-inflammatory molecules released in the endometrial tissue can cause DNA damage, which may lead to cancer development.
Metformin, an oral drug used to treat high blood sugar in T2DM, may be associated with a reduced risk of reproductive cancers. However, some studies have shown that metformin may not alter tumor proliferation in patients with endometrioid EC.
“This comprehensive clinical association pattern underscores the need for specialized care protocols for diabetic women with EC,” the authors wrote. “The complex interplay between T2DM and EC requires a multidisciplinary approach to optimize outcomes.”
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