Scholarlink

Background <p>The growing coexistence of diabetes and cancer contributes substantially to global morbidity and mortality. Beyond the independent burden of each disease, their intersection introduces unique challenges, particularly in cardiovascular risk. Patients with diabetes, especially those with underlying diabetic cardiomyopathy (DbCM), are at increased risk for cancer therapy-related cardiac dysfunction (CTRCD). Yet, the interplay between DbCM and CTRCD remains underexplored despite clear evidence of overlapping mechanisms and heightened vulnerability in this population.</p> Main text <p>DbCM and CTRCD share key pathophysiologic features, including oxidative stress, mitochondrial dysfunction, inflammation, fibrosis, and impaired calcium handling, which collectively reducing myocardial reserve during cancer therapy. Even in patients without overt DbCM, diabetes management complicates cancer care by influencing treatment tolerance and outcomes. Antidiabetic agents exert pleiotropic effects on both cardiac and oncologic pathways: insulin may worsen remodeling and potentially amplify tumorigenic signaling, whereas metformin and sodium-glucose cotransporter 2 inhibitors (SGLT2i) demonstrate promise for cardioprotection and modulation of cancer therapy responses. This review synthesizes the current evidence on shared pathobiology, highlights drug-drug interactions that may exacerbate cardiotoxicity and discusses therapeutic opportunities that could improve patient outcomes.</p> Conclusions <p>Understanding the intersection of diabetes and cancer is essential for reducing cardiac complications in this high-risk population. Integrated management strategies should prioritize early risk stratification, interdisciplinary collaboration, and judicious selection of antidiabetic therapies with cardioprotective potential. Research gaps remain in defining optimal monitoring protocols, refining pharmacologic strategies, and developing tailored guidelines. Addressing these gaps is critical to advancing cardio-oncology care and improving survivorship for patients living with both diabetes and cancer.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Diabetes and cancer: therapeutic implications

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月23日

查看全文
  • Stavros Fay,
  • Gabriella Bayshtok,
  • Carine E. Hamo,
  • Javed Butler,
  • Michelle Bloom

摘要

Background

The growing coexistence of diabetes and cancer contributes substantially to global morbidity and mortality. Beyond the independent burden of each disease, their intersection introduces unique challenges, particularly in cardiovascular risk. Patients with diabetes, especially those with underlying diabetic cardiomyopathy (DbCM), are at increased risk for cancer therapy-related cardiac dysfunction (CTRCD). Yet, the interplay between DbCM and CTRCD remains underexplored despite clear evidence of overlapping mechanisms and heightened vulnerability in this population.

Main text

DbCM and CTRCD share key pathophysiologic features, including oxidative stress, mitochondrial dysfunction, inflammation, fibrosis, and impaired calcium handling, which collectively reducing myocardial reserve during cancer therapy. Even in patients without overt DbCM, diabetes management complicates cancer care by influencing treatment tolerance and outcomes. Antidiabetic agents exert pleiotropic effects on both cardiac and oncologic pathways: insulin may worsen remodeling and potentially amplify tumorigenic signaling, whereas metformin and sodium-glucose cotransporter 2 inhibitors (SGLT2i) demonstrate promise for cardioprotection and modulation of cancer therapy responses. This review synthesizes the current evidence on shared pathobiology, highlights drug-drug interactions that may exacerbate cardiotoxicity and discusses therapeutic opportunities that could improve patient outcomes.

Conclusions

Understanding the intersection of diabetes and cancer is essential for reducing cardiac complications in this high-risk population. Integrated management strategies should prioritize early risk stratification, interdisciplinary collaboration, and judicious selection of antidiabetic therapies with cardioprotective potential. Research gaps remain in defining optimal monitoring protocols, refining pharmacologic strategies, and developing tailored guidelines. Addressing these gaps is critical to advancing cardio-oncology care and improving survivorship for patients living with both diabetes and cancer.