{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T09:40:10Z","timestamp":1777887610975,"version":"3.51.4"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Diabetes mellitus and cancer are among the most prevalent non-communicable diseases worldwide and increasingly coexist in clinical practice. Epidemiological evidence indicates that type 2 diabetes is associated with elevated risk of several malignancies, including hepatocellular, pancreatic, colorectal, endometrial, and breast cancers. At the same time, cancer and its treatments may significantly disrupt metabolic homeostasis and complicate glycemic control. Therapies such as glucocorticoids, PI3K inhibitors, and immune checkpoint inhibitors can induce hyperglycemia or precipitate new-onset diabetes. Metabolic dysregulation during cancer therapy has been associated with increased infection risk, treatment complications, and adverse clinical outcomes. This review summarizes the epidemiological evidence linking diabetes and cancer and discusses the clinical implications of their bidirectional interaction. The growing coexistence of both conditions highlights the need for integrated metabolic\u2013oncologic care. Proactive glycemic monitoring, individualized antidiabetic therapy selection, and multidisciplinary management may improve treatment tolerance and long-term outcomes in patients with cancer and diabetes.<\/jats:p>","DOI":"10.3389\/fonc.2026.1824109","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:18:41Z","timestamp":1777609121000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diabetes and cancer: clinical implications for integrated metabolic\u2013oncologic care"],"prefix":"10.3389","volume":"16","author":[{"given":"Vanessa","family":"Fuchs-Tarlovsky","sequence":"first","affiliation":[{"name":"Unidad de Investigaci\u00f3n en Nutrici\u00f3n Cl\u00ednica, Direcci\u00f3n de Investigaci\u00f3n, Hospital General de M\u00e9xico Dr. Eduardo Liceaga","place":["Mexico, Mexico"]},{"name":"Hospital Angeles Lomas","place":["Huixquilucan de Degollado, Mexico"]},{"name":"Centro de Cancer, Cl\u00ednica de Calidad de vida, Centro M\u00e9dico ABC (The American British Cowdary Medican Center)","place":["Mexico, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfaf177","article-title":"IDF Diabetes Atlas 11th edition 2025: global prevalence and projections for 2050","volume":"41","author":"Duncan","year":"2025","journal-title":"Nephrol Dial Transplant"},{"key":"B2","first-page":"1","article-title":"Association of type 2 diabetes with cancer: updated meta-analysis of cohort studies","volume":"65","author":"Ling","year":"2022","journal-title":"Diabetologia"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.26165","article-title":"Increased risk of hepatocellular carcinoma in patients with diabetes mellitus: a meta-analysis of cohort studies","volume":"56","author":"Wang","year":"2012","journal-title":"J Hepatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28123","article-title":"Association of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma in the United States","volume":"62","author":"Younossi","year":"2015","journal-title":"Hepatology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2011.03.003","article-title":"Diabetes mellitus and risk of pancreatic cancer: a meta-analysis of cohort studies","volume":"47","author":"Ben","year":"2011","journal-title":"Eur J Cancer"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.05.023","article-title":"Model to determine risk of pancreatic cancer in patients with new-onset diabetes","volume":"155","author":"Sharma","year":"2018","journal-title":"Gastroenterology"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji375","article-title":"Diabetes mellitus and risk of colorectal cancer: a meta-analysis","volume":"97","author":"Larsson","year":"2005","journal-title":"J Natl Cancer Inst"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-007-0681-5","article-title":"Diabetes mellitus and risk of endometrial cancer: a meta-analysis","volume":"50","author":"Friberg","year":"2007","journal-title":"Diabetologia"},{"key":"B9","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1038\/bjc.2012.414","article-title":"Diabetes and breast cancer risk: updated meta-analysis","volume":"124","author":"Boyle","year":"2021","journal-title":"Br J Cancer"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22717","article-title":"Diabetes mellitus and risk of breast cancer: a meta-analysis","volume":"121","author":"Larsson","year":"2007","journal-title":"Int J Cancer"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.epi-20-1245","article-title":"Type 2 diabetes and cancer: an umbrella review of meta-analyses of observational studies","volume":"6","author":"Pearson-Stuttard","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2011.06938.x","article-title":"Diabetes mellitus correlates with increased risk of pancreatic cancer: a population-based cohort study","volume":"41","author":"Liao","year":"2012","journal-title":"Pancreas"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0095485","article-title":"Diabetes mellitus and risk of hepatocellular carcinoma: a meta-analysis","volume":"8","author":"Li","year":"2017","journal-title":"Oncotarget"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2022.110328","article-title":"Association between diabetes and hepatocellular carcinoma risk in patients with NAFLD","volume":"71","author":"Kim","year":"2020","journal-title":"Hepatology"},{"key":"B15","doi-asserted-by":"publisher","first-page":"33","DOI":"10.21037\/tbcr-24-29","article-title":"Regulation of PI3K signaling in cancer metabolism and PI3K-targeting therapy","volume":"5","author":"Han","year":"2024","journal-title":"Transl Breast Cancer Res"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-020-0329-9","article-title":"Insulin-PI3K signalling: an evolutionarily insulated metabolic driver of cancer","volume":"16","author":"Hopkins","year":"2020","journal-title":"Nat Rev Endocrinol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"96","DOI":"10.3390\/jmp5010007","article-title":"Oxidative stress and ROS link diabetes and cancer","volume":"5","author":"Black","year":"2024","journal-title":"J Mol Pathol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1038\/s41568-024-00786-4","article-title":"Metabolic interplays between the tumour and the host shape the tumour macroenvironment","volume":"25","author":"Altea-Manzano","year":"2025","journal-title":"Nat Rev Cancer"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3390\/cimb47110929","article-title":"Interconnected mechanistic pathways, molecular biomarkers, and therapeutic approach of oral cancer in patients with diabetes mellitus","volume":"47","author":"Elian","year":"2025","journal-title":"Curr Issues Mol Biol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.08.029","article-title":"Pancreatic cancer-induced metabolic dysregulation syndrome: clinical profile, proposed mechanisms, and unanswered questions","volume":"167","author":"Patterson","year":"2024","journal-title":"Gastroenterology"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1530\/EDM-24-0040","article-title":"Hyperglycemia secondary to phosphatidylinositol-3 kinase (PI3K) inhibition","volume":"2024","author":"Sriravindrarajah","year":"2024","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1448728","article-title":"A comprehensive review of immune checkpoint inhibitor-related diabetes mellitus: incidence, clinical features, management, and prognosis","volume":"15","author":"Zhou","year":"2024","journal-title":"Front Immunol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-024-03942-w","article-title":"Immune checkpoint inhibitors-induced diabetes mellitus (review)","volume":"86","author":"Chen","year":"2024","journal-title":"Endocrine"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.clbc.2024.09.017","article-title":"Effective strategies for the prevention and mitigation of phosphatidylinositol-3-kinase inhibitor-associated hyperglycemia: optimizing patient care","volume":"25","author":"Moore","year":"2025","journal-title":"Clin Breast Cancer"},{"key":"B25","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Sung","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.6238","article-title":"Screening for colorectal cancer: US Preventive Services Task Force recommendation statement","volume":"325","author":"Davidson","year":"2021","journal-title":"JAMA"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29913","article-title":"Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American Association for the Study of Liver Diseases","volume":"68","author":"Marrero","year":"2018","journal-title":"Hepatology"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-012-2055-1","article-title":"Diabetes mellitus and the incidence of colorectal cancer: an updated meta-analysis","volume":"12","author":"Deng","year":"2021","journal-title":"Oncotarget"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21457","article-title":"Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society","volume":"68","author":"Wolf","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.4158\/EP08331.RAR","article-title":"Glucocorticoid-induced hyperglycemia","volume":"15","author":"Clore","year":"2009","journal-title":"Endocr Pract"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-08-2242","article-title":"Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment","volume":"15","author":"Prado","year":"2009","journal-title":"Clin Cancer Res"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1038\/nature05485","article-title":"Inflammation and metabolic disorders","volume":"444","author":"Hotamisligil","year":"2006","journal-title":"Nature"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-1996","article-title":"Cancer risk among people with type 1 and type 2 diabetes: disentangling true associations, detection bias, and reverse causation","volume":"38","author":"Harding","year":"2015","journal-title":"Diabetes Care"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000467","article-title":"Technological advances shaping diabetes care","volume":"26","author":"Akturk","year":"2019","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.824","article-title":"Long-term all-cause mortality in cancer patients with preexisting diabetes mellitus: a systematic review and meta-analysis","volume":"300","author":"Barone","year":"2008","journal-title":"JAMA"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-017-4372-6","article-title":"Repurposing metformin for the prevention of cancer and cancer recurrence","volume":"60","author":"Heckman-Stoddard","year":"2017","journal-title":"Diabetologia"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2014.003350","article-title":"Reviewing cancer care team effectiveness","volume":"11","author":"Taplin","year":"2015","journal-title":"J Oncol Pract"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.39.7356","article-title":"Management of metabolic effects associated with anticancer agents targeting the PI3K-Akt-mTOR pathway","volume":"30","author":"Busaidy","year":"2012","journal-title":"J Clin Oncol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-S002","article-title":"2. Diagnosis and classification of diabetes: Standards of Care in Diabetes-2024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2017.7412","article-title":"Metformin and cancer: an existing drug for cancer prevention and therapy","volume":"15","author":"Zi","year":"2018","journal-title":"Oncol Lett"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/519784","article-title":"Bone: incretin hormones perceiver or receiver","volume":"2012","author":"Dicembrini","year":"2012","journal-title":"Exp Diabetes Res"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-008-0083-2","article-title":"Sulphonylureas and cancer: a case-control study","volume":"46","author":"Monami","year":"2009","journal-title":"Acta Diabetol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.2337\/dcs13-2004","article-title":"Do GLP-1 based therapies increase cancer risk","volume":"36","author":"Nauck","year":"2013","journal-title":"Diabetes Care"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k4365","article-title":"Sodium glucose cotransporter 2 inhibitors and risk of serious adverse events: nationwide register based cohort study","volume":"363","author":"Ueda","year":"2018","journal-title":"BMJ"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1824109\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:18:42Z","timestamp":1777609122000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1824109\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":44,"alternative-id":["10.3389\/fonc.2026.1824109"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1824109","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]},"article-number":"1824109"}}