About this Research Topic
Diabetes mellitus (DM) is one of the major life-threatening diseases resulting in increased health care costs, deteriorated quality of life, and premature death, as well as malignant neoplasm. The prevalence of diabetes and malignancy has been increasing worldwide, presenting the hypothesis that there might be a potential direct relationship between DM and cancer morbidity or mortality.
The association of DM with malignancy has been discussed for decades. Throughout the literature, about 8% to 18% of individuals suffering from cancer also present diabetes. Comprehensive meta-analyses have indicated increased cancer incidence and cancer death in both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) worldwide. The association could come from overlapping risk factors between DM and cancer, including aging, obesity, smoking, and physical inactivity. Physiology and treatments of DM may also lead to this association. On the other hand, cancer patients with DM were usually treated via less aggressive approaches and got worse prognoses, compared with those without diabetes, suggesting a better control (prevention, detection, and management) of the growing epidemic of DM in order to decrease the health care burden and to improve the quality of life. It is also reported that stringent management of hyperglycemia and insulin resistance in DM patients accompanying cancer could improve their overall survival. If causal, these associations may have great importance for public health considering the substantial medical burden of these diseases around the globe.
The mechanisms underlying the relationship between DM and cancer have been investigated preliminarily. Proliferation and apoptosis pathways may be involved. Factors including hyperglycemia, hyperinsulinemia, insulin-like growth factor 1 (IGF-1), oxidative stress, and sex hormones, were presented. Supraphysiological concentrations of insulin and/or glycemia to which the human tissues are exposed have also been discussed.
While the results of studies focused on the relationship between diabetes and cancer-specific incidence and/or death are inconsistent. Both observational and experimental studies have suggested that medications used in DM treatment may be associated with either increased or decreased cancer risks. Meanwhile, selective reporting biases would also cause either false significance or an inflated estimation of the association. Thus, we should be careful when interpreting the study results, and methodological pitfalls should be avoided.
The aim of this Research Topic is to advance current knowledge on the biological mechanisms underlying the association of DM with cancer incidence and/or mortality. Well-designed randomized controlled trials (RCT) are also welcomed. Prospective or cross-sectional observational study will be considered. We also encourage negative retrospective reports with detailed information describing the association of DM with cancers. Systematic reviews and meta-analyses are especially welcomed. Topics of interest include the following aspects:
- Mechanisms and pathways related to the relationship between diabetes and malignancy.
- Epidemiological view of the association of diabetes and malignant neoplasm
- Analyses focused on eliminating the selective reporting biases of current publications.
- Studies revealing the effect of certain cancers on diabetes initiation and progression.
- Common biomarkers or risk factors related to the prevention, screening, or treatment of diabetes and malignancy.
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