Obesity and type 2 diabetes patients with poor glucose control are at a higher risk of developing cancer. Large, long-term weight loss appears to offer protection against cancer, but good glucose control reduces the number of cancer cases dramatically, according to a University of Gothenburg study.
Obesity is a known risk factor for both type 2 diabetes and several types of cancer. Similarly, intentional weight loss, such as bariatric surgery, often results in diabetes improvement, with many patients achieving normal blood-glucose control.
Cancer risk can be reduced in obese patients after significant, long-term weight loss. However, there have been few studies on the relationship between weight loss, cancer risk, and glucose control in patients with obesity and type 2 diabetes.
The current study, published in Diabetes Care, drew on data from the “SOS” (Swedish Obese Subjects) intervention trial, which is led and coordinated by the University of Gothenburg, as well as data from other sources, such as the Swedish Cancer Registry.
Many cancer cases among patients with type 2 diabetes are preventable, according to our findings. These findings make an important contribution to our understanding of the relationship between glucose control and cancer prevention.Kajsa Sjöholm
Cancer risk 60 percent lower
The researchers compared a group of 393 people with type 2 diabetes who had bariatric surgery to a control group of 308 people with the same clinical characteristics, i.e., severe obesity and type 2 diabetes but no bariatric surgery. In other ways, the two groups were comparable, such as gender composition, blood glucose levels, and smoking.
In the surgery group, 68 people (17 percent) developed cancer at the same time as they lost a significant amount of weight. In the control group, there were 74 (24 percent) new cancer cases, while these people remained severely obese. The average time between follow-ups was 21 years. Overall, the risk of getting cancer was 37 percent lower in the group that underwent obesity surgery.
However, when cancer risk was analyzed in patients who achieved normal glucose control and had no relapse of diabetes over a ten-year period, the largest difference was observed. Cancer occurred in only 12 out of 102 patients (12%), compared to 75 out of 335 (22%) in the group whose diabetes had recurred during the same time period. Thus, the results show a 60% reduction in cancer risk in the group that maintained normal glucose control over a 10-year period.
Guidance for preventing cancer
“Many cancer cases among patients with type 2 diabetes are preventable, according to our findings. These findings make an important contribution to our understanding of the relationship between glucose control and cancer prevention” The study’s first author, Kajsa Sjöholm, is an Associate Professor of Molecular Medicine at Sahlgrenska Academy, University of Gothenburg.
The study’s senior author is Magdalena Taube, Associate Professor of Molecular Medicine at Sahlgrenska Academy, University of Gothenburg.
“Obesity and diabetes are global epidemics that increase the risk of cancer as well as the risk of dying prematurely. Obesity is expected to cause more cancer cases than smoking in several countries over the next 10 to 15 years. This clearly demonstrates how serious the condition is “she claims.
“Strategies are required to prevent this progression, and our findings can provide critical guidance for cancer prevention in patients with obesity and type 2 diabetes,” Taube concludes.
Because success in the management of these diseases may well prevent the onset of other debilitating chronic diseases, the nutritional management of obesity, diabetes, and hypertension has been chosen as a first step for which nutritional guidelines should be established for management in the primary care system.
Nutritional management is a low-cost method of health care. As a result, careful consideration must be given to the role of nutrition in lowering costs, particularly those associated with certain medications, morbidity, length of hospital stay, and mortality. This can be accomplished by providing adequate, practical, and effective nutrition intervention based on scientific evidence.