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 The study included 524,089 men and women, ages 20 to 70, who didn't
have cancer or diabetes at the start. By the time half the
participants had been in the study for at least seven years, 15,130
people had developed cancer and 26,610 had developed diabetes.
Cancer patients were 35 percent more likely to develop diabetes than
people without malignancies, the study found. The excess diabetes
associated with tumors persisted even after accounting for other
diabetes risk factors like obesity, smoking and drinking.
"The reasons why patients with cancer may be at increased risk of
diabetes are unclear," said senior study author Juhee Cho of
Sungkyunkwan University in Seoul, South Korea.
In some cases, the cancer itself or treatments used to eradicate
tumors might cause diabetes, Cho said by email.
Also, Cho said, "cancer is a highly stressful experience, associated
with multiple high-stress episodes such as infections, bleeding
episodes, and surgery, that may also increase the risk of diabetes."
Worldwide, about one in 10 adults have diabetes.
Most have type 2 diabetes, which is associated with obesity and
aging and happens when the pancreas can't properly use or make
enough of the hormone insulin to convert blood sugar into energy.
Left untreated, diabetes can lead to nerve damage, amputations,
blindness, heart disease and strokes.
In the current study, the risk of diabetes varied by cancer type.
With pancreatic cancer, the increased risk of diabetes was more than
five-fold, while it was roughly doubled for liver and kidney
malignancies.
Gallbladder and lung tumors were associated with at least a 70
percent greater risk of diabetes. Breast, thyroid and stomach
malignancies were also tied to an increased risk of diabetes.
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Time also played a role, with a 47 percent greater risk of diabetes
in the first year or two after a cancer diagnosis. Six to ten years
after the cancer diagnosis, the increased diabetes risk was 19
percent.
The study wasn't a controlled experiment designed to prove whether
or how cancer itself or tumor treatments might directly cause
diabetes. It's also possible that some people in the study had
undiagnosed diabetes before they developed cancer, researchers note
in JAMA Oncology.
"A significant number of people are living with diabetes, but do not
know about it as they have no symptoms," said Tahseen Chowdhury, a
researcher at Royal London Hospital in the U.K. who wasn't involved
in the study.
Even so, the findings add to a growing body of evidence linking
cancer to diabetes, Chowdhury said by email.
"Cancer therapies such as steroids, and many chemotherapy and
radiotherapy regimes can increase glucose (or blood sugar) levels,"
Chowdhury said. "This may in part explain the link."
"A further important factor might be that many of these patients are
being seen (by doctors) frequently and having lots of blood tests,
which might mean their diabetes is picked up quicker than people who
do not have lots of blood tests," Chowdhury added.
SOURCE: http://bit.ly/2uagWsI JAMA Oncology, online June 7, 2018.
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