Diabetes Mellitus and Gastric Cancer: Correlation and Potential Mechanisms

Abstract

This review summarizes the correlation between diabetes mellitus (DM) and gastric cancer (GC) from the perspectives of epidemiology, drug use, and potential mechanisms. The association between DM and GC is inconclusive, and the positive direction of the association reported in most published meta-analyses suggests that DM may be an independent risk factor for GC. Many clinical investigations have shown that people with DM and GC who undergo gastrectomy may have better glycemic control. The potential link between DM and GC may involve the interaction of multiple common risk factors, such as obesity, hyperglycemia and hyperinsulinemia, H. pylori infection, and the use of metformin. Although in vitro and in vivo data support that H. pylori infection status and metformin can influence GC risk in DM patients, there are conflicting results. Patient survival outcomes are influenced by multiple factors, so further research is needed to identify the patients who may benefit.

Figure 1

Potential mechanisms between DM and GC. Abb: IL-2: interleukin-2; TNF-α: tumor necrosis factor alpha; INF-γ: interferon-gamma; TILS: tumor-infiltrating lymphocytes; IGF: insulin-like growth factor; IGFBP: insulin-like growth factor binding protein; VEGF: vascular endothelial growth factor; EMT: epithelial-mesenchymal transition.