title: From obesity to diabetes and cancer: epidemiological links and role of therapies.
abstract: Increasing evidence suggests a complex relationship between obesity, diabetes and cancer. Here we review the evidence for the association between obesity and diabetes and a wide range of cancer types. In many cases the evidence for a positive association is strong, but for other cancer types a more complex picture emerges with some site-specific cancers associated with obesity but not to diabetes, and some associated with type I but not type II diabetes. The evidence therefore suggests the existence of cumulative common and differential mechanisms influencing the relationship between these diseases. Importantly, we highlight the influence of antidiabetics on cancer and antineoplastic agents on diabetes and in particular that antineoplastic targeting of insulin/IGF-1 signalling induces hyperglycaemia that often evolves to overt diabetes. Overall, a coincidence of diabetes and cancer worsens outcome and increases mortality. Future epidemiology should consider dose and time of exposure to both disease and treatment, and should classify cancers by their molecular signatures. Well-controlled studies on the development of diabetes upon cancer treatment are necessary and should identify the underlying mechanisms responsible for these reciprocal interactions. Given the global epidemic of diabetes, preventing both cancer occurrence in diabetics and the onset of diabetes in cancer patients will translate into a substantial socioeconomic benefit.
authors.affiliation: Department of Basic Health Sciences, Faculty of Health Science, University Rey Juan Carlos, 28922 Alcorcon, Madrid, Spain.
authors.forename: Custodia
authors.initials: C
authors.lastname: García-Jiménez
authors.affiliation: Department of Basic Health Sciences, Faculty of Health Science, University Rey Juan Carlos, 28922 Alcorcon, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Gutiérrez-Salmerón
authors.affiliation: Department of Basic Health Sciences, Faculty of Health Science, University Rey Juan Carlos, 28922 Alcorcon, Madrid, Spain.|Ludwig Institute for Cancer Research, Nuffield Department of Clinical Medicine, University of Oxford, Headington, Oxford, UK.
authors.forename: Ana
authors.initials: A
authors.lastname: Chocarro-Calvo
authors.affiliation: Department of Basic Health Sciences, Faculty of Health Science, University Rey Juan Carlos, 28922 Alcorcon, Madrid, Spain.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: García-Martinez
authors.affiliation: Department of Basic Health Sciences, Faculty of Health Science, University Rey Juan Carlos, 28922 Alcorcon, Madrid, Spain.|Department of Pathology, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Castaño
authors.affiliation: Endocrine Tumour Unit (UFIEC), Instituto de Salud Carlos III, 28220 Majadahonda, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: De la Vieja
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D009765:Obesity / Q000150:complications*
chemical_list: D007004:Hypoglycemic Agents