Téma: Overview works

Diabetes mellitus type 2, metformin and neoplastic diseases

Zbynek Schroner

It is known, that 75 % of patients with type 2 diabetes mellitus die of cardiovascular diseases. Little is known about, that type 2 diabetics in comparison with non- diabetics the same age have increased morbidity and mortality of neoplastic diseases. Patients with type 2 diabetes have been associated with an increased risk of several types of tumors. The risk of pancreatic cancer in the first years after diagnosis of type 2 diabetes mellitus is two-fold, then this risk decreases to approximately 1,4. Type 2 diabetics in comparison with non- diabetics the same age have 1,5-3- times increased the risk of primary liver cancer and renal cancer. Type 2 diabetes mellitus is also a risk factor of colorectal carcinoma. Women with type 2 diabetes have been associated with an increased risk of breast and endometrial cancers. Metformin is known as insulin senzitizer, it decreases glycemias without stimulation of insulin secretion. At present, potential antineoplastic actions of metformin in patients with type 2 diabetes mellitus are intensively studied. Metformin may act as an antineoplastic agent by direct mechanism (activation of LKB1/AMPK pathway) and indirect mechanism (decreasing of hyperinsulinemia and levels of insulin-like growth factor-1). Some experimental and clinical data suggest that metformin may reduce the risk of cancer and also may decrease cancerrelated mortality in patients with type 2 diabetes mellitus. However, potential antineoplastic actions of metformin will need to be confirmed in other experimental and clinical studies.

Ročník 2008  Témy časopisu Internal medicine 3 / 2008

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prof. MUDr. Ivica Lazúrová, CSc. FRCP

REPRESENTATIVE OF CHAIRMAN
prof. MUDr. Juraj Payer, CSc., FRCP

MEMBERS OF THE EDITORIAL BOARD
doc. MUDr. Viera Fábryová, CSc.
MUDr. Viera Fedelešová, CSc.
prof. MUDr Martin Haluzík, CSc.
prof. MUDr. Štefan Hrušovský, CSc. Dr.SVS.
prof. MUDr. Rudolf Hyrdel, CSc.
doc. MUDr. Oľga Jurkovičová, CSc.
doc. MUDr. Zdenko Killinger, PhD.
doc. MUDr. Soňa Kiňová, PhD.
prof. MUDr. Peter Mitro, PhD.
doc. MUDr. Viliam Mojto, CSc., MHA
prof. MUDr. Karel Pacák, DrSc.
prof. MUDr. Juraj Payer, CSc., FRCP
doc. MUDr. Ján Podoba, CSc.
prof. MUDr. Igor Riečanský, DrSc.
doc. MUDr. Ján Staško, PhD.
doc. MUDr. Mária Szántová, PhD.
prof. MUDr. Ivan Tkáč, PhD.

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1. Shaheen NJ, Crosby NA, Bozymski EM, et al. Is there publication bias in the reporting cancer risk in Barrett ́ esophagus? Gastroenterology 2000; 119: 333-338.
2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285(4): 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
5. Osborne BE. The electrocardiogram of the rat. In: Budden R, Detweiler DK, Zbinden G. The rat electrocardiogram in pharmacology and toxicology. Oxford: Pergamon Press 1981: 15-27.

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c. propionibacterium acnes
d. endothelial growth factor


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