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Date of publication:2021/8/13 11:19:44
Diabetes is a common chronic disease. In China, the prevalence rate of diabetes is as high as 11.2%, which has become the second most chronic disease after hypertension. In many people's minds, although type 2 diabetes is common, it is not painful or itchy, and even if it is harmful, it will not cause serious consequences. But in fact, type 2 diabetes can not only cause serious complications such as ketoacidosis, hyperglycemia and hyperosmolality, nephropathy, retinopathy, neuropathy, and diabetic foot. More and more studies have found that type 2 diabetes is also  "entangled" with the dreaded disease cancer.  

Recently, a study published in the Journal of the National Cancer Institute added evidence for the association between type 2 diabetes and cancer. Studies have shown that type 2 diabetes is associated with an increased risk of a variety of cancers, especially in the 6-8 years after suffering from type 2 diabetes, the overall cancer risk has increased by nearly 40%.

the link between type 2 diabetes and cancer
Researchers from Harvard T.H. Chan School of Public Health and other institutions conducted a follow-up analysis of 159,033 subjects aged 30-75 years old in the United States, 71% of which were women.
Participants' basic health indicators, family history of cancer and type 2 diabetes, lifestyle, cancer screening history, chronic disease history, and treatment history were collected through questionnaires.  Levels of C-peptide and HbA1c were measured in blood samples to assess endogenous insulin secretion and glucose levels.  
In addition, the researchers also collected the incidence of cancer and type 2 diabetes during the study period and followed up the subjects every two years to update the information.
During the average follow-up period of 30 years, 43,849 cases of cancer occurred.
After adjusting for other factors, the researchers found that type 2 diabetes is associated with a higher risk of cancer.
Compared with subjects without type 2 diabetes, having type 2 diabetes is associated with a 21% increase in overall cancer risk. In terms of specific cancer types, type 2 diabetes is associated with an increased risk of more than 10 cancers, including a 21% increased risk of colorectal cancer, 27% increased risk of lung cancer, 107% increased risk of pancreatic cancer, 85% increased risk of esophageal cancer, 18% increased risk of kidney cancer, 239% increased risk of liver cancer, 49% increased risk of thyroid cancer, 33% increased risk of gallbladder cancer, 26% increased risk of breast cancer, and 26% increased risk of endometrial cancer.  
The study also found that the increased risk of cancer peaked between 6 and 8 years of type 2 diabetes.  

Compared with subjects without type 2 diabetes, duration of diabetes 2.1 to 4 years, 4.1 to 6 years, 6.1 to 8 years, 8.1 to 10 years, 10.1 to 15 years, and longer than 15 years were associated with an increased overall risk of cancer of 13%, 28%, 37%, 21%, 16%, and 4%, respectively.  The researchers found similar trends across different cancer types.  
Researchers analyzed that type 2 diabetes may increase the risk of cancer through various mechanisms such as insulin resistance, hyperinsulinemia, abnormal blood sugar control, and inflammation. However, the relevant biological mechanisms are not yet fully understood, and further research and exploration are still needed.
Since the study is an observational study, it only shows an association between type 2 diabetes and the overall risk of cancer and increased risk of multiple types of cancer, and does not indicate a causal relationship. There are also limitations to the study, such as part of the data relied on the recall of subjects. Changes in the lifestyle of some subjects following diagnosis of type 2 diabetes may also affect the results of the study.
The study finally emphasized that more and more evidence shows that there is a close link between type 2 diabetes and cancer risk. Type 2 diabetes may be a direct risk factor for cancer. In order to prevent the occurrence of cancer, type 2 diabetes should be prevented.
Researchers pointed out that type 2 diabetes and cancer have some common risk factors, such as excess weight, unhealthy diet, smoking, drinking, and lack of exercise. Management of these changeable risk factors, healthy living, enhanced screening and drug treatment will help to better reduce the risk of cancer and type 2 diabetes.
Weight control: Maintain a healthy weight. If you are overweight, obese or central obesity (waist circumference ≥90 cm for men, waist circumference ≥85 cm for women), you can lose weight through diet or exercise. The data show that the prevalence of type 2 diabetes in obese and overweight people has increased significantly, and the prevalence of type 2 diabetes has tripled among obese people. The incidence of type 2 diabetes was 7.8% in those with body mass index (BMI) < 25, 15.4% in those with 25≤BMI < 30, and 21.2% in those with BMI≥30.
Reasonable diet: Eat healthy and choose foods that are low in fat & calories and high in fiber.  Increase the intake of fruits, vegetables and whole grains and reduce the intake of sugar and salt.  
Quit smoking: A study conducted by researchers from the International Agency for Research on Cancer (IARC) and the European Prospective Investigation into Cancer and Nutrition (EPIC) found that smokers had a 35% increased risk of type 2 diabetes compared to non-smokers.  
Strengthen exercise: 
At least 150 minutes of moderate-intensity exercise or 75 minutes of high-intensity physical activity every week.
Avoid sedentary behavior: Sitting for a long time will increase the risk of illness. Try to get up and move for a few minutes after sitting for 30 minutes.
Diabetes screening: For people at high risk of type 2 diabetes, such as age 40 or higher, abnormal glucose tolerance, hypertension, dyslipidemia, overweight, obesity or central obesity, family history in first-degree relatives of type 2 diabetes and the woman who has a history of gestational diabetes should be timely screening for diabetes, early detection, early diagnosis and early treatment.  People with normal initial screening results should be screened at least once every three years.  
For diabetic patients, while adhering to medications and other treatments, they should maintain a healthy lifestyle to delay the progression of diabetes and complications, reduce disability and mortality, and improve the quality of life.
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Incident Type 2 Diabetes Duration and Cancer Risk: A Prospective Study in Two US Cohorts