Prediabetes Increases Cancer Risk

Prediabetes increases cancer risk

Life Extension Update

Wednesday, September 17, 2014. A meta-analysis described on September 11, 2014 in the journal Diabetologia adds evidence to an association between prediabetes and a greater risk of cancer. Prediabetes describes a stage between normal blood sugar levels and diabetes, and includes those with impairments in glucose tolerance and/or fasting glucose.

Yi Huang of China's First People's Hospital of Shunde and associates selected 16 prospective studies involving a total of 891,426 participants from different parts of the world for their analysis. They found a 15% higher risk of cancer among prediabetics that was consistent across ages, ethnicities and other factors. The lower definition of impaired fasting glucose used by the American Diabetes Association of 100 mg/dL to 124 mg/dL (5.6 mmol/L to 6.9 mmol/L) was associated with a risk of cancer that was not significantly different than that associated with prediabetes as defined by other organizations that utilize fasting plasma glucose levels of 110 mg/dL to 124 mg/dL (6.1 mmol/L to 6.9 mmol/L).

When cancer was evaluated according to type, the association was significant for stomach/colorectal, liver, pancreatic, breast and endometrial cancers. Liver cancer had the strongest association, with prediabetics experiencing nearly double the increase in risk.

The authors suggest that chronic oxidative stress and increased advanced glycation end products resulting from elevated blood glucose could be behind the increase in cancer risk uncovered in this analysis. Additionally, cancer cell growth can be stimulated by increased insulin secretion that occurs with insulin resistance. Furthermore, there may be genetic variations that increase the risk of cancer as well as prediabetes.

"It should be noted that metformin — one of several first line therapies available to treat type 2 diabetes — is now considered as having some 'protective' anticancer properties," Dr Huang and colleagues write. "Notably, metformin mediates an approximately 30% reduction in the lifetime risk of cancer in diabetic patients. However, whether this is true in prediabetic individuals is not yet known. Long-term, large-scale studies of high-risk individuals, especially those with impaired glucose tolerance or a combination of impaired glucose tolerance and impaired fasting glucose, are urgently needed to explore the effects of metformin interventions on the risk of cancer in people with prediabetes."

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Supplementation with magnesium lowers CRP in prediabetics
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An article published online on May 7, 2014 in the Archives of Medical Research reports the results of a double-blinded trial of subjects with prediabetes and low magnesium levels which found a benefit for magnesium supplementation in reducing C-reactive protein (CRP), a marker of inflammation.

The trial randomized 62 men and women between the ages of 18 to 65 years with newly diagnosed prediabetes who had magnesium levels below 1.8 mg/dL (0.74 mmol/L). Participants received an oral magnesium chloride solution containing 382 milligrams magnesium or a placebo daily for three months, and both groups received advice concerning physical activity and the components of a healthy diet. Plasma glucose, serum magnesium and high-sensitivity C-reactive protein (hsCRP) were measured before and after the treatment period.

By the end of the study, serum magnesium levels were higher, and fasting and two hour post-load glucose levels were lower among those who received magnesium in comparison with the placebo. While both groups experienced a decline in CRP, the decrease was significantly greater among those who received magnesium.

Authors Luis E. Simental-Mendía and colleagues note that magnesium deficiency has been proposed as an early factor in the activation of the inflammatory response. They recommend further clinical trials to establish whether magnesium deficiency plays a causative role in inflammation and to determine its mechanisms.

"Our results show that oral magnesium supplementation significantly decreases hsCRP levels in apparently healthy subjects with prediabetes and hypomagnesemia," the authors write. "Taking into account that elevated hsCRP is related to glucose metabolic disorders, our finding may have important implications in the policies focused in its prevention."


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Health Concern


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One of the best defenses against mild to moderate type 2 diabetes and hyperinsulinemia is improved diet and exercise. Although the disease has a genetic component, many studies have shown that diet and exercise can prevent it (Diabetes Prevention Program Research Group 2002; Diabetes Prevention Program Research Group 2003; Muniyappa 2003; Diabetes Prevention Program Research Group 2000). One study also showed that while some medications delay the development of diabetes, diet and exercise work better. Just 30 minutes a day of moderate physical activity, coupled with a 5 to 10 percent reduction in body weight, produces a 58 percent reduction in the incidence of diabetes among people at risk (Sheard 2003). The American Diabetes Association recommends a diet high in fiber, unrefined carbohydrates, and low in saturated fat (Sheard 2004). Foods with a low glycemic index are especially recommended because they blunt the insulin response.

In addition to diet and exercise, the prescription drug metformin has been proven to increase insulin sensitivity in people with mild to moderate hyperglycemia. Metformin is now the most commonly prescribed oral antidiabetic drug worldwide. It works by increasing insulin sensitivity in the liver (Joshi 2005). It also has a number of other beneficial effects, including weight loss, reduced cholesterol-triglyceride levels, and improved endothelial function.

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