Diabetes, Antidiabetic Medications and Cancer Risk in Type 2 Diabetes: Focus on SGLT-2 Inhibitors

• Published in: International journal of molecular sciences Vol. 22; no. 4; p. 1680
• Main Author: Dąbrowski, Mariusz
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 07-02-2021; MDPI
• Subjects: Antidiabetics; Bladder cancer; Body weight; Breast cancer; Cancer; Colorectal cancer; Cytokines; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - drug therapy; DPP-4 inhibitors; GLP-1 receptor agonists; Glucose; Growth factors; Hormones; Humans; Hyperglycemia; Hyperinsulinemia; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - adverse effects; Incidence; Inflammation; Insects; Insulin; Insulin resistance; Insulin-like growth factors; Ligands; Lung cancer; Malignancy; Metabolism; Metformin; Neoplasms - chemically induced; Neoplasms - epidemiology; Obesity; Ovaries; Oxidation resistance; Oxidative stress; Peptide hormones; Peptides; Prostate; Proteins; Review; Risk analysis; Risk Factors; Sodium-Glucose Transporter 2 Inhibitors - administration & dosage; Sodium-Glucose Transporter 2 Inhibitors - adverse effects; Steroids; sulfonylureas; thiazolidinedions; Thyroid gland; Tumor necrosis factor-TNF; United States - epidemiology; United States; thiazolidinedions; metformin; insulin; DPP-4 inhibitors; GLP-1 receptor agonists; sulfonylureas
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms22041680

In the last decade, cancer became the leading cause of death in the population under 65 in the European Union. Diabetes is also considered as a factor increasing risk of cancer incidence and mortality. Type 2 diabetes is frequently associated with being overweight and obese, which also plays a role in malignancy. Among biological mechanisms linking diabetes and obesity with cancer hyperglycemia, hyperinsulinemia, insulin resistance, increased levels of growth factors, steroid and peptide hormones, oxidative stress and increased activity of pro-inflammatory cytokines are listed. Antidiabetic medications can modulate cancer risk through directly impacting metabolism of cancer cells as well as indirectly through impact on risk factors of malignancy. Some of them are considered beneficial (metformin and thiazolidinedions-with the exception of bladder cancer); on the other hand, excess of exogenous insulin may be potentially harmful, while other medications seem to have neutral impact on cancer risk. Inhibitors of the sodium-glucose cotransporter-2 (SGLT-2) are increasingly used in the treatment of type 2 diabetes. However, their association with cancer risk is unclear. The aim of this review was to analyze the anticancer potential of this class of drugs, as well as risks of site-specific malignancies associated with their use.