Diabetes refers to a group of chronic health conditions that affect how the body uses blood sugar (glucose). Research has shown that people with type 2 diabetes have a 20 percent higher risk of developing blood cancers, including leukemia. There is likely a relationship between type 1 diabetes and a person’s risk for early-onset leukemia. MyLeukemiaTeam members have also reported having diabetes alongside leukemia — particularly chronic myelogenous leukemia (CML) and chronic lymphocytic leukemia (CLL).
This article explores the connection between leukemia and diabetes. A health care provider is the best resource if you or a loved one is suspected of having one or both conditions.
Diabetes (also referred to as diabetes mellitus) is a group of diseases, all of which affect how the body uses glucose — a sugar that provides energy to muscle and tissue cells.
Much of the food a person eats is broken down into glucose and then released into the bloodstream. A rise in blood sugar causes the pancreas to release insulin, a hormone that allows glucose to enter the body’s cells for use as energy. In people with diabetes, the body doesn’t produce enough insulin (type 1), or cells do not respond correctly to insulin (type 2).
When the body doesn’t make enough insulin or can’t use it correctly, an excess of sugar remains in the bloodstream. Over time, high blood sugar levels can lead to serious health problems and complications, including kidney disease, heart disease, nerve damage, and vision loss.
Diabetes is usually chronic (lifelong), or it may potentially be reversible. Chronic forms of diabetes include type 1 and type 2 diabetes.
Type 1 diabetes is thought to result from an autoimmune response. The immune system mistakenly attacks the body’s healthy cells, causing the pancreas to produce little to no insulin. Type 1 accounts for roughly 5 percent to 10 percent of all cases of diabetes. Currently, experts do not know how to prevent a person from developing type 1 diabetes.
Type 2 diabetes occurs when the body’s ability to regulate and use glucose is impaired. The pancreas produces enough insulin, but the cells do not respond well to insulin, causing them to take in less glucose. Approximately 90 percent to 95 percent of people with diabetes in the United States have type 2 diabetes.
Research has shown that type 1 diabetes and type 2 diabetes are potentially risk factors for leukemia. Both type 1 and type 2 are called diabetes mellitus. It has also been found that in rare cases, diabetes insipidus can precede the development of acute myeloid leukemia (AML), but it is important to know that diabetes insipidus is not the same disease as diabetes mellitus.
According to a 2012 meta-analysis, individuals with type 2 diabetes have a 20 percent higher risk of developing blood cancers, including myeloma, non-Hodgkin lymphoma, and leukemia. The analysis looked at 26 research articles investigating the connection between type 2 diabetes and the incidence of blood cancers. Among more than 17,000 cases of blood cancer and type 2 diabetes, it was determined that people with type 2 diabetes have an increased chance of developing leukemia, as well as myeloma, non-Hodgkin lymphoma, and a subtype of non-Hodgkin lymphoma called peripheral T-cell lymphoma.
What is the cause of this relationship? Findings from researchers at the Mayo Clinic point to the disruption of glucose metabolism in diabetes. Disturbances in the way the body uses blood sugar in type 2 diabetes can lead cancer cells to increase their uptake of glucose, which can help them grow and divide more than usual. Other explanations include mediating factors that increase the risk for both diabetes and leukemia, such as obesity and smoking.
A 2012 study found evidence for a relationship between type 1 diabetes and a child’s risk of leukemia (early-onset leukemia).
Several reasons for this relationship were proposed. The researchers noted the possibility that insulin therapy — which is used to treat people with type 1 diabetes and some with type 2 diabetes — could lead to leukemia. They also mentioned that it is possible, although unlikely, that metabolic disruptions and high glucose levels before insulin therapy could trigger leukemia, similarly to the proposed association between leukemia and type 2 diabetes.
More likely, the researchers noted, was the possibility that both type 1 diabetes and early-onset leukemia share their origins in viral infection. Type 1 diabetes is increasingly thought to be due to an abnormal response to infection with an enterovirus. According to the study, enterovirus RNA has been found in the blood and pancreatic tissues of children with type 1 diabetes and leukemia.
Diabetes insipidus is a type of diabetes that causes a person to excrete large amounts of very diluted (watered-down) urine — a condition known as polyuria. Polyuria is a symptom present in people with both diabetes mellitus and insipidus. Otherwise, the two conditions are not the same. One case study determined that polyuria caused by diabetes insipidus may, in rare cases, precede the development of acute monocytic leukemia, but the mechanisms behind the relationship are not yet clear.
According to the Mayo Clinic’s research, having diabetes does not increase the risk of death in people with acute myeloid leukemia or chronic myeloid leukemia. It was also found that leukemia did not affect diabetic individuals’ ability to control their blood sugar levels.
These findings are significant, as studies have shown that people with diabetes face an increased risk of death from certain solid cancers (cancers that form tumors, unlike blood cancer). More studies are needed to confirm the findings.
Navigating life with leukemia can be challenging. The good news is that you don’t have to go it alone.
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