TY - JOUR
T1 - Confounding factors of the diabetes – metformin – cancer relationship
AU - Aldea, Mihaela
AU - Crăciun, Lucian
AU - Popescu, Tiberiu
AU - Nenu, Iuliana
AU - Crivii, Carmen
N1 - Publisher Copyright:
© 2014 ILEX PUBLISHING HOUSE, Bucharest, Roumania.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - An increasing wealth of knowledge in oncology and diabetes points to metformin, the most widely used oral anti-diabetic worldwide, as a potential anticancer drug. Metformin has not only been shown to reduce the risk of developing cancer, but recent studies have also highlighted the impact that this drug might have on cancer aggressiveness, progression and survival. Several categories of confounding factors, some of them not taken into account in current clinical studies, may lead to an incorrect estimation of the true effect that metformin might have in cancer patients. It is important to assess whether the insulin lowering effects of metformin may constitute the main antineoplastic mechanism of action or if this may be due to an underlying direct effect. Such reasons warrant that new prospective research should take into account patient insulin levels, the duration and doses of metformin treatment and also include a cohort of non-diabetic patients for comparison. Measurement of the optimal antineoplastic dosage of metformin and proper quantification of established confounding factors will likely lead to a better understanding and estimation of metformin’s true anti-cancer effects, ultimately resulting in a better clinical management for diabetic patients with cancer.
AB - An increasing wealth of knowledge in oncology and diabetes points to metformin, the most widely used oral anti-diabetic worldwide, as a potential anticancer drug. Metformin has not only been shown to reduce the risk of developing cancer, but recent studies have also highlighted the impact that this drug might have on cancer aggressiveness, progression and survival. Several categories of confounding factors, some of them not taken into account in current clinical studies, may lead to an incorrect estimation of the true effect that metformin might have in cancer patients. It is important to assess whether the insulin lowering effects of metformin may constitute the main antineoplastic mechanism of action or if this may be due to an underlying direct effect. Such reasons warrant that new prospective research should take into account patient insulin levels, the duration and doses of metformin treatment and also include a cohort of non-diabetic patients for comparison. Measurement of the optimal antineoplastic dosage of metformin and proper quantification of established confounding factors will likely lead to a better understanding and estimation of metformin’s true anti-cancer effects, ultimately resulting in a better clinical management for diabetic patients with cancer.
KW - Cancer
KW - Confounding factors
KW - Diabetes
KW - Metformin
UR - http://www.scopus.com/inward/record.url?scp=84907066820&partnerID=8YFLogxK
U2 - 10.2478/rjdnmd-2014-0029
DO - 10.2478/rjdnmd-2014-0029
M3 - Review article
AN - SCOPUS:84907066820
SN - 1583-8609
VL - 21
SP - 239
EP - 246
JO - Romanian Journal of Diabetes, Nutrition and Metabolic Diseases
JF - Romanian Journal of Diabetes, Nutrition and Metabolic Diseases
IS - 3
ER -