Цукровий діабет та онкологічні захворювання
DOI:
https://doi.org/10.37987/1997-9894.2021.2(248).229022Анотація
Щорічно зростає кількість уперше виявлених випадків як цукрового діабету (ЦД), так і різних онкологічних захворювань. Очевидно, що наявність одного захворювання значно ускладнює перебіг іншого. Але досі незрозуміло, чи ЦД потенціює розвиток раку, чи онкопатологія є причиною порушень вуглеводного обміну, і який вплив на перебіг раку має застосування антидіабетичних препаратів.
Метою даного огляду було встановити причинно-наслідковий зв’язок між ЦД, застосуванням гіпоглікемічної терапії та розвитком онкопатології.
Результати. Виявлено, що гіперінсулінемія та гіперглікемія послідовно посилюють ймовірність розвитку пухлини не тільки у хворих на ЦД, а й у пацієнтів з предіабетом, та призводять до розвитку деяких видів раку, наприклад, раку підшлункової залози, печінки, шлунка, товстої кишки, молочної залози, нирок, легень тощо. Крім того, побічним ефектом застосування деяких антидіабетічних препаратів може бути підвищення або зниження ризику розвитку онкопатології на тлі діабету.
Висновки. ЦД є фактором ризику розвитку раку, особливо гепатоцелюлярного, гепатобіліарного, підшлункової залози, раку молочної залози, яєчників, ендометрія і шлунково-кишкового тракту. Загалом лікування препаратами сульфонілсечовини може збільшити ризик розвитку раку, тоді як лікування, пов’язане з поліпшенням резистентності до інсуліну, наприклад, метформіном, може знизити цей ризик. Очевидно, що чимало наявних досліджень мають неоднозначні результати та потребують коригування через організаційні помилки, тобто необхідне проведення додаткових ретельно спланованих і правильно організованих досліджень. Крім того, з огляду на вагомість обох захворювань, ми вважаємо, що хворим на ЦД необхідний рутинний скринінг і орієнтування медперсоналу на раннє виявлення онкопатології.
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