IMPLICATIONS OF THE HYPERINSULINEMIA-DIABETES-CANCER LINK FOR PREVENTIVE EFFORTS

Recent epidemiological evidence points to a link between non-insulin d ependent diabetes mellitus type II (NIDDM) and cancer of the colon, li ver, pancreas, breast and endometrium. This appears to be due to the l ong period of hyperinsulinaemia which precedes the clinical phase of N IDDM, insulin promoting colon tumour development as well as acting as a hepatocarcinogen. Indeed, the hormone could play a central role in n eoplasia, and its influence could explain the observed enhancing effec ts of obesity and a high fat diet, as well as the inhibition associate d with physical exercise, dehydroepiandrosterone administration and hi gh soluble fibre intake. Measures to decrease insulin levels, includin g lifestyle improvement and supplementation with agents known to decre ase insulin resistance may therefore offer a general approach to preve ntion of cancer in a wide variety of organ sites of major clinical imp ortance. (C) Lippincott-Raven Publishers.