Royal Marsden Hospital, London, UK.
Chelsea and Westminster Hospital, London, UK.
J Hum Nutr Diet. 2023 Apr;36(2):504-513. doi: 10.1111/jhn.13051. Epub 2022 Jul 24.
Diabetes and cancer are both common and increasingly prevalent conditions, but emerging epidemiological evidence confirms that the risk of developing a number of common cancers is increased in those with type 2 diabetes. The risk of cancer in type 1 diabetes is less clearly defined, and therefore this review focuses on type 2 diabetes. Emerging evidence also supports an influence of diabetes on outcomes of cancer treatment. However, this relationship is bi-directional, with cancer and its treatment impacting on glucose control, whereas there is also emerging evidence indicating that diabetes care can deteriorate after a cancer diagnosis. Despite these clear links, there is a lack of evidence to guide clinicians in how to manage patients with diabetes during their cancer treatment. Although recent UK guidelines have started to address this, with the development of guidance for the management of hyperglycaemia in cancer, there is a clear need for wider guidance on the management of multi-morbidity during cancer, including diabetes and obesity, to incorporate nutritional management. We have therefore undertaken a narrative review of the evidence of links between type 2 diabetes and cancer incidence and outcomes, and discuss the challenges to diabetes care during cancer treatment.
糖尿病和癌症都是常见且日益流行的疾病，但新出现的流行病学证据证实，2 型糖尿病患者发生多种常见癌症的风险增加。1 型糖尿病的癌症风险定义不太明确，因此本综述重点关注 2 型糖尿病。新出现的证据也支持糖尿病对癌症治疗结果的影响。然而，这种关系是双向的，癌症及其治疗会影响血糖控制，而新出现的证据也表明，癌症诊断后糖尿病的治疗也可能恶化。尽管存在这些明确的关联，但缺乏证据指导临床医生在癌症治疗期间如何管理糖尿病患者。尽管最近的英国指南已经开始对此进行处理，制定了癌症患者高血糖管理指南，但显然需要更广泛的指导，以管理癌症期间的多种合并症，包括糖尿病和肥胖症，以纳入营养管理。因此，我们对 2 型糖尿病与癌症发病率和结局之间的关联证据进行了叙述性综述，并讨论了癌症治疗期间糖尿病管理面临的挑战。
