Weight Loss Intervention in People with Type 2 Diabetes Influences Cancer-Associated Proteins

According to Diabetes UK, over five million people in the UK live with diabetes and over 600 million people could be afflicted worldwide by 2045. Weight loss is now a key intervention thanks to the Diabetes Remission Clinical Trial (DiRECT), which found a dietary weight loss programme could put type 2 diabetes into remission.  

Despite this positive development, individuals with type 2 diabetes face an increased risk of developing several types of cancer. Previous studies have found that having increased body weight alters the levels of circulating proteins with a known link to cancer. Motivated by these findings, researchers from Bristol Medical School collaborated with colleagues from the universities of Glasgow and Newcastle who led the DiRECT trial. They sought to evaluate whether the benefits of weight loss in people with type 2 diabetes also impacts their risk of developing cancer.

To investigate this, the team used data from 261 patients with type 2 diabetes who were enrolled in the DiRECT trial. The team analysed their blood samples from before and after weight loss to find out if proteins known to be related to cancer were altered by the weight loss intervention.

Nine cancer-related proteins in blood samples were found to be changed by the weight loss intervention compared with the control group who had received standard care for diabetes treatment.

Emma Hazelwood, one of the study’s lead authors from the University of Bristol’s MRC Integrative Epidemiology Unit (MRC IEU), said: "Results from this study help us gain insight into potential mechanisms linking type 2 diabetes and body fatness with cancer development. These findings offer encouraging evidence that the increased cancer risk seen in people with diabetes might be reduced with weight loss interventions. This has important implications for both diabetes treatment and cancer prevention.

"The next step for this research is to find out whether the short-term changes we identified really do result in longer-term reduction in cancer risk in people with diabetes."

The study was funded by Diabetes UK, Cancer Research UK, World Cancer Research Fund, and Wellcome.

Paper

'Impact of weight loss on cancer-related proteins in serum: results from a cluster randomised controlled trial of individuals with type 2 diabetes' by Caroline J. Bull, Emma Hazelwood et al. in eBioMedicine [open access]

Further information

About type 2 diabetes
People with type 2 diabetes don’t produce enough insulin or the insulin they produce doesn’t work properly (known as insulin resistance). Around 90 per cent of people with diabetes have type 2. They might get type 2 diabetes because family history, age and ethnic background puts them at increased risk. They are also more likely to get type 2 diabetes if they are living with obesity or overweight. People from the most deprived areas are also more at risk of developing type 2. It starts gradually, usually later in life, and it can be years before they realise they have it. However, we are seeing more young people, including children, developing it. Type 2 diabetes is treated by getting support to manage your weight, eating a healthy diet and increasing physical activity. In addition, medications including tablets, insulin and non-insulin injectables are usually required.  

About Diabetes UK 

1.   Diabetes UK’s aim is creating a world where diabetes can do no harm. Diabetes is the most devastating and fastest growing health crisis of our time, affecting more people than any other serious health condition in the UK - more than dementia and cancer combined. There is currently no known cure for any type of diabetes. With the right treatment, knowledge and support people living with diabetes can lead a long, full and healthy life.

2.   Diabetes is a condition where there is too much glucose in the blood because the body cannot use it properly. Without the support to manage it well, both type 1 and type 2 diabetes can lead to devastating complications. Diabetes is one of the leading causes of preventable sight loss in people of working age in the UK and is a major cause of lower limb amputation, kidney failure and stroke.   

About the MRC Integrative Epidemiology Unit (IEU)
The MRC Integrative Epidemiology Unit (IEU) at the University of Bristol conducts some of the UK's most advanced population health science research. It uses genetics, population data and experimental interventions to look for the underlying causes of chronic disease. The unit exploits the latest advances in genetic and epigenetic technologies. They develop new analytic methods to improve our understanding of how our family background behaviours and genes interact to influence health outcomes.

About Integrative Cancer Epidemiology Programme (ICEP)
The Integrative Cancer Epidemiology Programme (ICEP) builds on our world-leading expertise in causal analysis (specifically, Mendelian randomization) and population-based bioinformatics and genomic sciences. These methods facilitate robust discrimination between causal exposures that are possible targets for behavioural or therapeutic interventions to prevent cancer (primary prevention) or its progression (tertiary prevention), from non-causal biomarkers which may nevertheless act as predictive biomarkers (secondary prevention). ICEP is funded by Cancer Research UK.

About Wellcome 
Wellcome supports science to solve the urgent health challenges facing everyone. We support discovery research into life, health and wellbeing, and we’re taking on three worldwide health challenges: mental health, infectious disease and climate and health. 

About Cancer Research UK

• Cancer Research UK is the world’s leading cancer charity dedicated to saving lives through research.
• Cancer Research UK’s pioneering work into the prevention, diagnosis and treatment of cancer has helped save millions of lives.
• Cancer Research UK receives no funding from the UK government for its life-saving research. Every step it makes towards beating cancer relies on vital donations from the public.
• Cancer Research UK has been at the heart of the progress that has already seen survival in the UK double in the last 40 years.
• Today, 2 in 4 people survive their cancer for at least 10 years. Cancer Research UK’s ambition is to accelerate progress so that by 2034, 3 in 4 people will survive their cancer for at least 10 years.
• Cancer Research UK supports research into all aspects of cancer through the work of over 4,000 scientists, doctors and nurses.
• Together with its partners and supporters, Cancer Research UK's vision is to bring forward the day when all cancers are cured.

For further information about Cancer Research UK's work or to find out how to support the charity, please call 0300 123 1022. Follow us on Twitter and Facebook

About World Cancer Research Fund
World Cancer Research Fund examines how diet, nutrition, body weight and physical activity affect your risk of developing and surviving cancer. As part of an international network of charities, we have been funding life-saving research, influencing global public health policy, and educating the public since 1982. While society continues searching for a cure, our prevention and survival work is helping people live longer, happier, healthier lives – free from the devastating effects of cancer. 

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