Impact of diabetes on the increased risk of hepatic cancer: An updated review of biological aspects
Bhrigu Kumar Das, Pramod C. Gadad
Abstract
The concurrence of diabetes (predominantly type II) and hepatic cancer with the growing burden of evidence have generated global attention, posing a challenge in defining the possible association or molecular link between these diseases. Hence, the complex pathophysiological relationship is challenging to elucidate; still, multiple meta-analyses of epidemiological reports suggest that the prevalence of diabetes significantly increases the risk of developing hepatic cancer. This association has hypothesized several pathophysiological mechanisms, such as hyperglycemia, hyperinsulinemia, insulin resistance, obesity, and enhanced inflammatory processes. The treatment with metformin, a well-known biguanide class of anti-diabetic drugs, is associated with a lower incidence of hepatic cancer. This review addresses and summarizes the current understanding of the potential biological link/mechanism between diabetes and hepatic cancer incidence and prognosis. Lastly, we have also outlined the possible role of metformin in reducing the overall hepatic cancer risk.