- Colon cancer risk is higher among type 2 diabetes patients
- Tests to identify the high risk group for colon cancer among diabetes patients can help in early diagnosis and treatment of the cancer
- Researchers explored the possibility of using GLUT4 expression and natural killer (NK) cell number to identify the risk.
Patients with diabetes are at a higher risk for colon cancer. High glucose and fasting insulin levels, as well as insulin resistance associated with diabetes, promote the growth of cancer. Other factors like obesity, sedentary lifestyle and unhealthy diet contribute to the development of both colon cancer and diabetes.
‘Identification of diabetes patients at a high risk for colon cancer can enable better monitoring and early detection of the cancer.’
AdvertisementGlucose enters the cells through specific transporters, among which GLUT4 is extremely common. Cancer cells require excess glucose to meet their metabolic needs and express more number of these receptors.
Certain white blood cells in the blood called natural killer cells (NK cells) are the first cells to fight cancers. Cancer patients appear to have a lesser number and reduced activity of NK cells, which show a further decline as the severity of the cancer increases.
Researchers estimated the GLUT4 expression and NK cells number in patients suffering from both colon cancer and type 2 diabetes. They compared their findings with those in patients suffering from either colon cancer or type 2 diabetes, as well as in normal individuals. The cancers in the subjects were localized to the colon and had not spread, and the patients underwent surgery to remove cancer within two weeks of the diagnosis. Diabetes was being treated with diet control with or without oral anti-diabetes medications.
The final analysis was carried out on 78 subjects. Parameters used to measure diabetes control included fasting plasma glucose, glycated hemoglobin (HbA1c), insulin level, insulin resistance index and oral glucose tolerance test. The number of NK cells in the blood and GLUT4 expression was estimated.
The researchers found the following:
- Patients with type 2 diabetes alone had the highest expression of GLUT4 in NK cells as compared to the other groups. This could be a compensatory mechanism to overcome insulin resistance.
- The GLUT4 expression was reduced in NK cells in those with colon cancer with or without diabetes
- Diabetes patients with colon cancer were mostly being treated with sulfonylureas, while those without cancer were being treated with metformin. Therefore, it is possible that metformin may play a role in preventing colon cancer in diabetes patients.
- Piątkiewicz P, Bernat-Karpińska M, Miłek T, Rabijewski M and Rosiak E. NK cell count and glucotransporter 4 (GLUT4) expression in subjects with type 2 diabetes and colon cancer. Diabetology & Metabolic Syndrome20168:38 DOI: 10.1186/s13098-016-0152-6