2.8 Diabetes & Cancer

Question 1

Type 1 or 2 is the most common type of diabetes?

Answer 1

Type 2

Question 2

Define diabetes

Answer 2

A metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood

• level of sugar’s too high in the blood stream

Question 3

What are signs of diabetes?

Answer 3

Polyuria (excessive urination)
Polydipsia (excessive drinking)
Polyphagia (excessive eating)

Question 4

Describe type 1 diabetes

Answer 4

• Also called juvenile diabetes
• In children and young adults
• Bodies own immune system destroys insulin in pancreas
• Beta cells in pancreas become inactive
• Not preventable

Question 5

Causes of type 1 diabetes

Answer 5

Predisposition to diabetes
Genetics
Something in environment

Question 6

In type 1 diabetes, does the body produce insulin?

Answer 6

No

Question 7

Describe type 2 diabetes

Answer 7

• Most common form
• also called adult onset diabetes, or non-insulin dependent diabetes
• People have small amount of insulin or non-working insulin in body (can’t use insulin properly)
• Can develop at any age
• Can be prevented

Question 8

Risk factors of diabetes

Answer 8

• Genetics
• Family history
• Racial background
• Age
• Environmental factors (inactivity or weight gain)

Question 9

Normal blood sugar levels

Answer 9

70-140

Question 10

Prediabetes blood sugar level

Answer 10

141-200

Question 11

Diabetes blood sugar level

Answer 11

200 and above

Question 12

Hyperglygemia

Answer 12

Elevated sugar level’s in blood

Question 13

Periodontitis and diabetes steps for hyperglygemia

Answer 13

Hyperglygemia –> AGE (advanced glycation end products) –> RAGE (receptor for advanced glycation end product) in PMN, macrophages, and monocytes –> increase in IL1-beta and TNF-alpha

Question 14

Define hemoglobin A1C

Answer 14

Measurement of stable hemoglobin complex in bloodstream

• Gives the big picture

Question 15

Describe glycated hemoglobin (A1C)

Answer 15

• A form of hemoglobin that’s covalently bound to glucose

- Hemoglobin is exposed to glucose in blood and bound together

Question 16

Describe HbA1C test

Answer 16

Determines the 3 month average blood sugar level

• In diabetes, higher amounts of glycated hemoglobin indicate poorer control of blood glucose levels

Question 17

HbA1c test results for diabetics should at at ___%

Answer 17

7%

Question 18

Normal and prediabetic HbA1C percentage

Answer 18

Normal = <5.7%
Prediabetic = 5.7-6.4%

Question 19

Define advanced glycation end products (AGEs)

Answer 19

Proteins or lipids that become glycated as a result of exposure to sugars

Question 20

Higher levels of ___ are found in vegetarians

Answer 20

AGEs

Question 21

What happens when AGEs bind to RAGE?

Answer 21

Causes oxidative stress and activation of inflammatory pathways in vascular endothelial cells

• Leads to periodontitis

Question 22

What are the complications for uncontrolled diabetes?

Answer 22

Foot lesions, nephropathy, retinopathy, stroke, cardiovascular disease, and periodontitis

Question 23

Cancers most commonly diagnosed in men

Answer 23

Prostate
Lung/bronchus
Colon/rectum

Question 24

Most common cancers diagnosed in women

Answer 24

Breast
Lung/bronchus
Colon/rectum

Question 25

Is there a meaningful association between diabetes and cancer incidence or prognosis?

Answer 25

Yes, but NOT to prostate cancer - Positive association between diabetes and pancreatic cancer risk

Question 26

What are the nonmodifiable risk factors common to both diabetes and cancer?

Answer 26

Age Sex Race/ethnicity

Question 27

Cancer and diabetes occurs more commonly in men or women?

Answer 27

Men

Question 28

What race/ethnicity is more likely to die from cancer?

Answer 28

African Americans

Question 29

What modifiable risk factors are common to both diabetes and cancer?

Answer 29

``` Overweight/obesity/weight change Physical activity Tobacco smoking and cancer Tobacco smoking and diabetes Alcohol Sugar drinks ```

Question 30

What cancer's are associated with overweight and obesity?

Answer 30

``` Breast Colon/rectum Endometrium Pancreas Adenocarcinoma ```

Question 31

There is a strong association between obesity and both insulin resistance and type ___ diabetes incidence

Answer 31

2

Question 32

Physical activities is associated with

Answer 32

Lower levels of cancer and diabetes if you maintain activity

Question 33

Tobacco smoking and cancer accounts for what types of cancer deaths?

Answer 33

Trachea, bronchus and lung

Question 34

Smoking is an ___ risk factor for diabetes

Answer 34

Independent

Question 35

Alcohol increases the incidence of what types of cancers?

Answer 35

Oral cavity, pharynx, larynx, esophagus, liver, colon/rectum, and female breast

Question 36

What are the possible biologic links between diabetes and cancer risk?

Answer 36

``` Malignant transformation Insulin/IGF axis Effect of hyperinsulinemia on other hormones Inflammatory cytokines Hyperglycemia ```

Question 37

What are malignant transformation steps?

Answer 37

1. Initiation 2. Promotion (stimulation of growth of initiated cells) 3. Progression (development of a more aggressive phenotype of promoted cells)

Question 38

Describe insulin/IGF axis

Answer 38

They form a complex network of cell surface receptors that mediate IGF responses - Interferes with cell's ability to interact with other cells

Question 39

What are the effects of hyperinsulinemia on other hormones

Answer 39

- Increased levels of testosterone in women - Increased levels of estrogen in men and women - Reduction in hepatic synthesis and blood levels of sex hormone binding globulin

Question 40

Define hyperglycemia

Answer 40

High levels of blood sugar can lead to cancer proliferation

Question 41

Types of diabetes treatments

Answer 41

Metformin Thiazolidenediones Insulin and insulin analogs

Question 42

Describe metformin

Answer 42

- Most common prescribed initial or combination therapy for diabetics - Inhibits cell proliferation, reduce colony formation, causes partial arrest in cancer cell lines

Question 43

Describe thiazolidenediones

Answer 43

- an oral drug used to control blood sugar

Question 44

Describe insulin and insulin analogs

Answer 44

- In patients that have high insulin levels | - The insulin receptor is present on neoplastic cells and may influence neoplastic behavior

Question 45

The association between diabetes and cancer may partly be due to shared ___

Answer 45

risk factors

Question 46

Possible mechanisms for the ___ of diabetes and cancer include hyperinsulinemia, hyperglycemia, and inflammation

Answer 46

Direct link

Question 47

What diabetes treatment is associated with reduced risk of cancer?

Answer 47

Metformin

Question 48

What diabetes treatment is associated with higher risk of cancer?

Answer 48

Exogenous