Endocrine Abstracts

Introduction: Diabetes mellitus (DM) has become a global health concern, associated with increased mortality and morbidity rate. The escalating incidence of DM, particularly type 2 DM (T2DM), aligns with the rising rates of various cancers, hinting at a plausible direct connection between DM and cancer. Mounting evidence suggests that DM may contribute to the heightened incidence of endometrial cancer (EC) and underscores its correlation with poor prognosis. Individuals with DM face double the risk of progressing to EC, possibly due to the conducive environment for the growth and invasiveness of EC cells in high-glucose conditions. Given the inadequacy of existing treatments to prevent or delay EC progression, early and effective prevention through glucose metabolism interventions remains as promising approach.

Materials and Methods: A comparative analysis published data from MEDLINE, EMBASE, PubMed, and Research Gate was conducted through the systemic search over the past 2 years.

Results: Most epidemiological studies highlight association between EC and T2DM. Analysis of T2DM’s impact on cancer risk unveils a significant increase in both morbidity and mortality for EC. Early-stage DM, besides T2DM patients, exhibits a 4.9% heightened risk of EC. T1DM also correlates with an elevated risk of EC. Additionally, DM emerges as an independent risk factor for EC mortality. Biological Mechanisms: Mounting evidence suggests that insulin resistance (IR) and hyperinsulinemia, mediated by insulin and insulin-like growth factors, influence endometrial cells and signaling pathways such as PI3K, MAPK/ERK, and VEGFR, thereby promoting angiogenesis and EC occurrence. Chronic inflammation factors like TNFα, IL-6, and COX-2 contribute to carcinogenesis.

Conclusion: This study enriches the comprehension of the intricate relationship between DM and EC, providing a global outlook on the effects of DM on EC through diverse mechanisms. It underscores the clinical potential of antidiabetic medications for EC, furnishing invaluable insights for future research and therapeutic strategies.