What You Need to Know About the Cancer-Diabetes Connection

There are more connections between diabetes and cancer than you’d expect. Research suggests the two can be intimately related — with some cancer treatments putting patients at risk for insulin dependence, and type 2 diabetes greatly increasing a person’s susceptibility to cancer.

Because cancer and both types 1 and 2 diabetes can weaken the immune system, people with these disorders are also at increased risk of of severe illness from COVID-19, according to the U.S. Centers for Disease Control and Prevention (CDC).^[1]

Cancer and diabetes are connected

In type 1 diabetes, the body no longer sufficiently produces insulin. In type 2 diabetes, the body may still be producing insulin, but other metabolic cells of the body become resistant to its effects (insulin resistance). Insulin, a hormone the pancreas makes to allow cells to use glucose, remains the standard treatment option for millions of people living with diabetes.^[2] In 1978 at City of Hope, a biomedical research complex and National Cancer Institute-designated comprehensive cancer center in Southern California, Arthur Riggs, Ph.D., and Keiichi Itakura, Ph.D., conducted research that led to the invention of synthetic human insulin, which transformed modern diabetes management. In 2017, City of Hope founded the Wanek Family Project for Type 1 Diabetes, an ambitious program designed to rapidly translate laboratory discoveries into new treatments — and eventually a cure — for type 1 diabetes.

Cancer and diabetes are “two sides of the same coin” because at a fundamental level both are disruptions of the body’s normal metabolism. For example, people with type 2 diabetes are twice as likely to develop liver or pancreatic cancer and run a higher-than-normal risk of developing colon, bladder and breast cancer. City of Hope’s Debbie C. Thurmond, Ph.D., explained that obesity is a major risk factor for both cancer and type 2 diabetes. “Excess fat may provoke the disruption of the body’s normal metabolism and increase inflammation, which is a known trigger for both diabetes and cancer,” she said.

Diabetes and COVID-19 also appear to be connected

While there’s still much to learn about COVID-19, recent data from the CDC reported more than three-quarters of people who died from COVID-19 had at least one preexisting condition. Specifically, diabetes was noted as an underlying condition in approximately four out of 10 patients. Among people younger than 65 who died from the infection, about half had diabetes.^[3]

Managing diabetes during COVID-19

People with diabetes — type 1 or type 2 — are more susceptible to contracting COVID-19 than others, and have poorer outcomes if they do. City of Hope’s Ping H. Wang, M.D., noted, “Patients with diabetes have higher risks of serious complications and ketoacidosis from COVID-19,” and explained that warning signs of severe infection are heightened shortness of breath, persistent chest pain and an intense feeling of fatigue. Even mild symptoms should not be ignored, he said. If you are experiencing any flu-like symptoms, Wang said you should call your physician and continue to monitor your blood glucose.

Managing your diabetes as the first line of defense against the novel coronavirus

It’s critical that those battling cancer and/or type 1 or 2 diabetes stay informed and take necessary precautions, which may include:

• Controlling underlying medical conditions better
• Maintaining blood glucose in the target range
• Engaging in physical activities recommended by your doctor
• Controlling eating behavior
• Making sure you’re taking all of your medications correctly
• Social distancing, wearing a face mask and maintaining hand hygiene

For more information on City of Hope’s Diabetes & Metabolism Research Institute, clinical trials and innovative diabetes research, visit CityofHope.org/diabetes-awareness.

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[1] U.S. Centers for Disease Control and Prevention (CDC). People with Certain Medical Conditions. Available at https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

[2] American Diabetes Association. Insulin Basics. Available at https://www.diabetes.org/diabetes/medication-management/insulin-other-injectables/insulin-basics

[3] STAT News. Why people with diabetes are being hit so hard by Covid-19. Available at https://www.statnews.com/2020/10/01/why-people-with-diabetes-are-being-hit-so-hard-by-covid-19/