How diabetes medications may influence cancer risk and progression

Diabetes, particularly Type 2 Diabetes (T2DM), has been linked to an increased risk of various cancers, including liver, colorectal, and breast cancer. While glycemic control and weight management are crucial in managing diabetes, emerging evidence suggests these factors alone are insufficient to explain the full impact on cancer risk. This has prompted an exploration into how anti-diabetic medications might influence cancer beyond their role in controlling blood sugar and body weight. By addressing this gap, researchers aim to better understand how these medications could potentially offer benefits or pose risks in the context of cancer prevention and treatment. Given these challenges, further studies are required to fully understand the mechanisms involved.

Published (DOI: 10.1093/pcmedi/pbaf028) on December 10, 2025, in Precision Clinical Medicine, this review article explores the impact of anti-diabetic medications on cancer, moving beyond the conventional focus on glycemic control and weight management. The research, conducted by experts at Peking University People's Hospital, examines how medications like metformin, SGLT2 inhibitors, and GLP-1 receptor agonists might alter cancer progression through various biological pathways, offering new insights into the complex relationship between diabetes treatments and cancer outcomes.

The review systematically examines the preclinical and clinical evidence linking anti-diabetic medications to cancer. Metformin, one of the most widely used anti-diabetic drugs, is shown to influence cancer through various mechanisms, including enhancing anti-cancer immunity and inhibiting tumor growth by affecting the tumor microenvironment (TME). It also modifies the activity of key cancer-related pathways like AMPK, mTOR, and PI3K/AKT, which are involved in cell proliferation, apoptosis, and angiogenesis. Similarly, other medications like SGLT2 inhibitors and GLP-1 receptor agonists have shown potential in altering cancer cell proliferation, reducing inflammation, and promoting apoptosis. However, their effects vary depending on the type of cancer and specific drug used. For example, while metformin has shown promise in reducing the risk of colorectal and liver cancers, its effects on breast cancer remain inconclusive. Furthermore, the review highlights the importance of considering individual medications and their specific mechanisms of action, as well as the need for further clinical trials to confirm these findings and explore their therapeutic potential in cancer treatment.

According to Dr. Linong Ji, one of the leading researchers in this field, "While anti-diabetic medications are crucial in managing diabetes, their broader effects on cancer are still not fully understood. This review sheds light on the intricate mechanisms through which these drugs may influence cancer progression. However, the evidence is mixed, and we must continue to investigate the long-term impacts of these medications in cancer patients, as well as the potential for developing targeted therapies based on these findings."

The findings from this review underscore the importance of personalized medicine in treating diabetic patients with cancer. Understanding the specific ways anti-diabetic medications influence cancer progression could lead to better-targeted treatments, improving both cancer prevention and patient outcomes. This research also paves the way for future clinical trials to explore how existing medications can be optimized for cancer therapy or used as adjuncts to conventional treatments. The role of medications like metformin in cancer prevention could also inform public health strategies, particularly in managing diabetes and related comorbidities in populations at higher risk for cancer.