A diabetes drug may play a role in preventing leukemia

blood cancer condition characterized by high levels of sugar (glucose) in the blood. The most common types are Type 1 and Type 2 diabetes, each with distinct causes and treatment approaches. In Type 1 diabetes, the body’s immune system attacks insulin-producing cells, leading to insulin deficiency. Type 2 diabetes, which is more common, involves insulin resistance where the body doesn’t use insulin properly. Both types require careful management to prevent complications.

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A study published by the American Hematology Society indicated that the drug Metformin shows effectiveness as a preventive agent for some types of cancer and reducing their development, especially myeloproliferative tumors, which are a group of rare and malignant types of blood cancer.

Metformin is a treatment used to control blood sugar levels in patients with type 2 diabetes, by enhancing the sensitivity of cells to insulin and reducing the liver’s secretion of glucose.

It has recently appeared in studies as one of the promising strategies for cancer prevention as a result of observing its positive effect in combating the formation and development of some tumors in individuals with tumors who take metformin compared to patients with the same type of tumor but who do not take metformin.

Also, the study researchers noted that the protective effect of long-term use of metformin was observed in all types of myeloproliferative tumors.

However, it is worth noting that the study was limited, and other factors that may increase or decrease the risk of cancer, such as smoking, obesity, and dietary habits, were not evaluated.

In conclusion, there is still a need for more studies and clinical trials on metformin and its effectiveness in preventing cancer, but the results so far are considered promising.

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blood cancer  A first-of-its-kind study unveils how diabetes drives multiple myeloma growth and differences in survival outcomes for Black versus white patients with both conditions.

Patients with multiple myeloma, a blood cancer of plasma cells in the bone marrow, who also have diabetes have a reduced overall survival when compared to those without diabetes. In a subgroup analysis, this difference in survival due to diabetes was seen in white patients but not in Black patients, according to a study published today in Blood Advances.

According to the Centers for Disease Control and Prevention, diabetes affects 13% of the U.S. population, and this prevalence is growing rapidly. Multiple myeloma is the second most common blood cancer in the U.S. and disproportionately affects non-Hispanic Black adults, in whom it is the most common blood cancer.

While investigators have long been aware of the increased risk of multiple myeloma in patients with diabetes, this is the first study to examine racial disparities in survival rates among those living with these comorbid conditions.

“We knew from prior studies that patients with multiple myeloma and diabetes have lower survival rates,” explained Urvi Shah, MD, a multiple myeloma specialist at Memorial Sloan Kettering Cancer Center. “But what we did not know is how these outcomes differ between races. Diabetes is much more common in Black individuals versus white individuals, and we wanted to understand whether this difference may play a role in health outcomes among patients with both conditions.”

Researchers conducted a retrospective study, collecting data from electronic health care records of 5,383 patients with multiple myeloma from two academic medical centers: Memorial Sloan Kettering Cancer Center and Icahn School of Medicine at Mount Sinai. Fifteen percent of patients included had a diabetes diagnosis (12% of white and 25% of Black patients).

Across the board, Dr. Shah and colleagues observed that among patients with myeloma, those with diabetes had poorer survival rates than those without. When analyzing results by race, however, they found that while white patients with myeloma and diabetes had lower survival rates than those without diabetes, they did not observe this finding among Black patients.

“What we did not expect to see here was that diabetes was actually associated with worse survival outcomes among white individuals with myeloma, but not Black individuals,” said Dr. Shah.

Dr. Shah added that generally, one’s risk of developing diabetes increases with age. Study findings also show that overall survival decreased with age. Notably, however, in this cohort, diabetes was 50% more prevalent among Black patients 45-60 years old than white patients over 60 years old. Younger patients may tolerate multiple myeloma treatments better than older individuals, and these differences could explain some of the racial differences investigators observed in survival outcomes.

When investigating the mechanisms behind these findings, Dr. Shah and colleagues observed that in genetically engineered mouse models, multiple myeloma tumors grew more rapidly in non-obese diabetic mice than in non-diabetic controls.

After studying the biological mechanisms underlying tumor growth in these mice, researchers found that an insulin-related signal was overactivated in the diabetic mice, leading them to believe that higher insulin levels associated with diabetes may accelerate cancer growth.

“In my own practice, I work with many patients with both multiple myeloma and diabetes. And usually treating multiple myeloma involves many rounds of chemotherapy,” said Dr. Shah. “But this study suggests that we may also improve patient outcomes further by treating diabetes at the same time.”

Of note, this study was retrospective, and its findings do not account for how the quality of care patients with diabetes receive may impact survival outcomes, something Dr. Shah strives to better understand with future research. Further limitations include that race was self-reported and limited to the academic centers the patients included were referred to for care.

Going forward, Dr. Shah and colleagues aim to identify therapies that stop both the development of multiple myeloma and the overactive insulin signaling pathway they believe may be prevalent in patients with multiple myeloma and diabetes. Dr. Shah is also investigating how modifiable risk factors like the microbiome and one’s diet can be altered to improve cancer outcomes.

“While drugs are important, as oncologists, we need to also look at comorbidities and modifiable risk factors to improve patient survival outcomes. Therapies and lifestyle changes can go hand in hand,” Dr. Shah emphasized.

Diabetes refers to a group of chronic health conditions that affect how the body uses blood sugar (glucose). Research has shown that people with type 2 diabetes have a 20 percent higher risk of developing blood cancers, including leukemia. There is likely a relationship between type 1 diabetes and a person’s risk for early-onset leukemia. MyLeukemiaTeam members have also reported having diabetes alongside leukemia — particularly chronic myelogenous leukemia (CML) and chronic lymphocytic leukemia (CLL).

This article explores the connection between leukemia and diabetes. A health care provider is the best resource if you or a loved one is suspected of having one or both conditions.

blood cance What Is Diabetes?

Diabetes (also referred to as diabetes mellitus) is a group of diseases, all of which affect how the body uses glucose — a sugar that provides energy to muscle and tissue cells.

Much of the food a person eats is broken down into glucose and then released into the bloodstream. A rise in blood sugar causes the pancreas to release insulin, a hormone that allows glucose to enter the body’s cells for use as energy. In people with diabetes, the body doesn’t produce enough insulin (type 1), or cells do not respond correctly to insulin (type 2).

When the body doesn’t make enough insulin or can’t use it correctly, an excess of sugar remains in the bloodstream. Over time, high blood sugar levels can lead to serious health problems and complications, including kidney disease, heart disease, nerve damage, and vision loss.

blood cance Type 1 Diabetes vs. Type 2 Diabetes

Diabetes is usually chronic (lifelong), or it may potentially be reversible. Chronic forms of diabetes include type 1 and type 2 diabetes.

Type 1 diabetes is thought to result from an autoimmune response. The immune system mistakenly attacks the body’s healthy cells, causing the pancreas to produce little to no insulin. Type 1 accounts for roughly 5 percent to 10 percent of all cases of diabetes. Currently, experts do not know how to prevent a person from developing type 1 diabetes.

Type 2 diabetes occurs when the body’s ability to regulate and use glucose is impaired. The pancreas produces enough insulin, but the cells do not respond well to insulin, causing them to take in less glucose. Approximately 90 percent to 95 percent of people with diabetes in the United States have type 2 diabetes.

blood cance Research on Leukemia and Diabetes

Research has shown that type 1 diabetes and type 2 diabetes are potentially risk factors for leukemia. Both type 1 and type 2 are called diabetes mellitus. It has also been found that in rare cases, diabetes insipidus can precede the development of acute myeloid leukemia (AML), but it is important to know that diabetes insipidus is not the same disease as diabetes mellitus.

blood cance Type 2 Diabetes and Leukemia

According to a 2012 meta-analysis, individuals with type 2 diabetes have a 20 percent higher risk of developing blood cancers, including myeloma, non-Hodgkin lymphoma, and leukemia. The analysis looked at 26 research articles investigating the connection between type 2 diabetes and the incidence of blood cancers. Among more than 17,000 cases of blood cancer and type 2 diabetes, it was determined that people with type 2 diabetes have an increased chance of developing leukemia, as well as myeloma, non-Hodgkin lymphoma, and a subtype of non-Hodgkin lymphoma called peripheral T-cell lymphoma.

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What is the cause of this relationship? Findings from researchers at the Mayo Clinic point to the disruption of glucose metabolism in diabetes. Disturbances in the way the body uses blood sugar in type 2 diabetes can lead cancer cells to increase their uptake of glucose, which can help them grow and divide more than usual. Other explanations include mediating factors that increase the risk for both diabetes and leukemia, such as obesity and smoking.

blood cance Type 1 Diabetes and Leukemia

A 2012 study found evidence for a relationship between type 1 diabetes and a child’s risk of leukemia (early-onset leukemia).

Several reasons for this relationship were proposed. The researchers noted the possibility that insulin therapy — which is used to treat people with type 1 diabetes and some with type 2 diabetes — could lead to leukemia. They also mentioned that it is possible, although unlikely, that metabolic disruptions and high glucose levels before insulin therapy could trigger leukemia, similarly to the proposed association between leukemia and type 2 diabetes.

More likely, the researchers noted, was the possibility that both type 1 diabetes and early-onset leukemia share their origins in viral infection. Type 1 diabetes is increasingly thought to be due to an abnormal response to infection with an enterovirus. According to the study, enterovirus RNA has been found in the blood and pancreatic tissues of children with type 1 diabetes and leukemia.

blood cance Diabetes Insipidus and Leukemia

Diabetes insipidus is a type of diabetes that causes a person to excrete large amounts of very diluted (watered-down) urine — a condition known as polyuria. Polyuria is a symptom present in people with both diabetes mellitus and insipidus. Otherwise, the two conditions are not the same. One case study determined that polyuria caused by diabetes insipidus may, in rare cases, precede the development of acute monocytic leukemia, but the mechanisms behind the relationship are not yet clear.

blood cance Diabetes and Leukemia Survival

According to the Mayo Clinic’s research, having diabetes does not increase the risk of death in people with acute myeloid leukemia or chronic myeloid leukemia. It was also found that leukemia did not affect diabetic individuals’ ability to control their blood sugar levels.

These findings are significant, as studies have shown that people with diabetes face an increased risk of death from certain solid cancers (cancers that form tumors, unlike blood cancer). More studies are needed to confirm the findings.

blood cance Meet Your Team

Navigating life with leukemia can be challenging. The good news is that you don’t have to go it alone.

MyLeukemiaTeam is the social network for people with leukemia and their loved ones. Here, members from across the world come together to ask questions, offer support and advice, and share stories of their everyday lives with leukemia.