Get 3 for the Price of 1: Cancer, Diabetes, Alcoholism

Rishabh Gaur - Department of Oncology

Link: https://www.nature.com/articles/s41598-023-36472-y

The article “High burden of diabetes and prediabetes among cancer patients at University of Gondar comprehensive specialized hospital, Northwest Ethiopia” by Wolde et al. examined the prevalence of prediabetes and diabetes among cancer patients and identified associated factors. The study found that 56.8% of cancer patients had diabetes, while 16.7% had prediabetes. Alcohol consumption was identified as an independent risk factor for elevated blood sugar levels among cancer patients. Noncommunicable diseases (diseases that aren’t passed from person to person) like diabetes and cancer are rising fastest in developing countries like Ethiopia. It is estimated these countries are responsible for 77% of the world’s diabetes epidemic. While the paper’s observations about Ethiopian cancer patients are clear, due to its cross-sectional design, it cannot be used to establish causation, especially with its small sample size.

Diabetes and cancer share many risk factors, including age, obesity, diet, alcohol, smoking, and inactivity. There also could be a bidirectional risk relationship between diabetes and cancer. Cancer treatments, such as corticosteroids and certain chemotherapies, may contribute to increased blood sugar levels, which would lead to insulin resistance. Another possible mechanism for this link between cancer and diabetes is that cancer patients often lose weight and appetite, developing cancer cachexia syndrome which is linked to an impaired ability to tolerate glucose and ultimately, diabetes. Also, cancer patients who consume alcohol have higher odds of elevated blood sugar levels compared to those who do not because alcohol consumption can impair pancreatic function and increase insulin resistance. Conversely, Diabetes can help the cancer to spread, often by depressing the affected individual’s immune system. This feedback loop between cancer and diabetes highlights the importance of looking at health and disease with a broader lens to catch these common associations and insure patients are treated appropriately.

References

Wolde, H.F., Molla, M.D., Aragie, H. et al. High burden of diabetes and prediabetes among

cancer patients at University of Gondar comprehensive specialized hospital, Northwest

Ethiopia. Sci Rep 13, 9431 (2023). https://doi.org/10.1038/s41598-023-36472-y