Higher cancer risk in diabetic women

Women with diabetes are 27 per cent likelier to develop cancer than women without diabetes, according to a new global review.

Genetics and diet may play a part in type 1 diabetes. Picture: Istock

More than 1.2 million Australian adults have diabetes, based on latest estimates, and prevalence of this chronic condition tripled in the 15 years to 2014-15. It is slightly more common among men, increases with age and is twice as high in the lowest socio-economic group compared with the highest. In 2015, 16,400 Australians died because of diabetes, the victims likelier to live in remote areas, especially Aboriginal communities. Given the growing impact diabetes is having on Australians, researchers and medical practitioners are keen to better prevent, diagnose and treat the condition.

Women with diabetes are 27 per cent likelier to develop cancer than women without diabetes, while for men the risk is 19 per cent higher, according to a new global review. The review, published in the journal Diabetologia, analysed data from 47 studies of populations including the US, Japan, China, Britain and Australia. It also found women with diabetes were 6 per cent likelier overall to develop any form of cancer than men with diabetes. “The link between diabetes and the risk of developing cancer is now firmly established,” says Toshiaki Ohkuma, from the George Institute for Global Health. “We have also demonstrated for the first time that women with diabetes are more likely to develop any form of cancer and have a significantly higher chance of developing kidney, oral and stomach cancers, and leukaemia.” Co-author Sanne Peters says the reasons for the gender differences, possibly including a delay in diagnosis and treatment for diabetes, need further investigation.

A drop in the levels of the coenzyme Q10 (CoQ), which plays a role in energy production in cells, leads to increased levels of oxidants and the onset of pre-diabetes and could be targeted by medical interventions. The research, conducted in experimental laboratory settings, mouse models and samples from humans, involved a collaboration between the University of Sydney, Victor Chang Cardiac Research Institute, Duke University school of medicine, Garvan Institute of Medical Research, the University of NSW and Genentech. “Replenishing CoQ could prove an invaluable preventive measure for insulin resistance or pre-diabetes-linked diseases such as type 2 diabetes, cardiovascular disease, cancers and dementia,” says co-author Roland Stocker, from the Victor Chang Cardiac Research Institute and UNSW. “However, oral CoQ supplements may not effectively restore mitochondrial CoQ due to its low absorption. This work has provided an impetus for us to find alternate means.”

Genetics and diet may play a part in type 1 diabetes, creating an opportunity for medicine to target where they meet in the gut. University of Queensland researcher Emma Hamilton-Williams investigated differences in the gut microbiota, comparing those susceptible to type 1 diabetes with those protected against it. “This research has shown there is a genetic component to microbiota and the immune response involved in regulating it,” Hamilton-Williams says. “This means that changes in the microbiota in type 1 diabetes occur before symptoms develop and are not just a side effect of the disease. Therapies targeting the microbiota could therefore have the potential to help prevent type 1 diabetes in the future.” The research also showed that an immunotherapy targeting T-cells associated with type 1 diabetes resulted in dramatic changes in the gut biology and altered the microbiota in mice. “The implications are that a person’s genetics contribute to an unhealthy microbiota as well as their diet,” Hamilton-Williams says.

A diabetes pen containing two types of insulin has been listed on the Pharmaceutical Benefits Scheme as of Wednesday. Ryzodeg will help more than 118,000 Australians living with type 1 and type 2 diabetes regulate their blood sugar levels more easily and cost-effectively. It also can be delivered as a once-daily injection, helping maintain their health. Diabetes Australia welcomed the announcement from federal Health Minister Greg Hunt. “Managing blood glucose levels can be difficult but it is the cornerstone of diabetes management and critical to the prevention of long-term diabetes-related complications like limb amputation, blindness, kidney and heart disease and others,” Diabetes Australia says. “Recent data shows that only 50 per cent of Australians with diabetes are meeting blood glucose targets so it is important they can access the medicines that support optimal blood glucose management.”