Evidence less consistent for high blood sugar, insulin treatment and oral agents

Charles H. Hennekens, M.D., Dr.P.H., the first Sir Richard Doll professor and senior academic advisor to the dean in the Charles E. Schmidt College of Medicine at Florida Atlantic University was senior author of a consensus statement from the American Association of Clinical Endocrinologists (AACE) on diabetes and cancer, which was just published in Endocrinology Practice. Recently, concerns have been raised that medications used to control blood sugar among diabetics may be associated with an increased prevalence of multiple cancers. The AACE recently commissioned a conference and task force to make recommendations for practicing clinicians.

In this publication, Hennekens and co-authors conclude that there is currently sufficient evidence to conclude that obesity and diabetes are associated with various cancers. In contrast, however, there is currently insufficient evidence that drugs used to control blood sugar among diabetics are associated with an increased cancer risk.

"Obesity is perhaps the major risk factor for type 2 diabetes as well as multiple cancers including pancreatic and colon cancers," said Hennekens. "The evidence is less consistent for high blood sugar, insulin treatment as well as oral agents."

These experts conclude that clinicians can continue to confidently prescribe all FDA-approved medications to diabetics for the management of blood sugar according to established practice guidelines. Hennekens also adds that "the serious and life threatening risks of low blood sugar in diabetes are definite." He also notes that prior concerns about higher death rates in diabetics who attain adequate control of their blood sugar are premature and unwarranted.

The multidisciplinary and internationally acclaimed task force also recommends to clinicians the improved treatment and management of obesity as well as early cancer screening in patients at increased risk. They also recommend to researchers increased collaboration and improved study designs to address outstanding concerns surrounding the interrelationships of obesity, diabetes, its therapy and various cancers.

Hennekens is a major advocate of a healthy lifestyle. He strongly advises the general public that cardiovascular drugs of lifesaving benefit should be adjuncts not alternatives to therapeutic lifestyle changes. Specifically, the major therapeutic lifestyle changes they advocate include avoidance and cessation of smoking, avoidance and treatment of obesity, and regular physical activity, which could be as minimal as taking brisk 20 minute daily walks, which can be continued even among the elderly.