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J Nutr Hum Health 2017 Volume 1 Issue 2
Page 27
Notes:
July 24-26, 2017 | Vancouver, Canada
International conference on
DIABETES, NUTRITION, METABOLISM & MEDICARE
allied
academies
O
besity and its metabolic complications, including
diabetes, have been associated with an increased risk
of several cancers. Thus, the potential use of Metformin
as a novel cancer prevention strategy has generated much
excitement in view of its low cost, favorable safety profile,
and its potential for biological specificity in disrupting the
association between obesity and cancer. Metformin seems
to affect multiple key processes related to cell growth,
proliferation, and survival which stem from both metabolic
and intracellular-signaling activity. Metformin decreases
hepatic glucose production and reduces the bloodstream
level and cellular uptake of insulin which results in reduced
activation of insulin receptors on cell membranes, triggering
a cascade of intracellular molecular effects, which are often
activated in many types of cancer cells, in addition to up
regulation of AMP-activated protein kinase, a key molecule
in glucose and insulin regulation and also an inhibitor of
mTOR. Treatment with Metformin has been associated in
meta-analysis of case–control and cohorts with reduced
breast, colon and pancreas cancer risk, although RCTs
confirmed the inverse association or showed no impact of
Metformin. It should be remembered that RCTs that find no
association between Metformin and cancer were designed
to analyze other outcomes, did not include adequate
confounding factors and follow-up was too short (maximum
4 years). Despite this evidence the latest meta-analysis
shows that Metformin decreased risk only for cancers of the
liver, pancreas, colorectal and stomach. A meta-analysis of
8 cohorts, involving 2805 pancreatic patients with diabetes,
demonstrated a favorable result for pancreatic cancer
with improved overall survival (HR=0.78, 95% CI=0.66-
0.92). Metformin treatment is associated with a significant
reduction in overall mortality irrespective of diabetes status
in patients with endometrial cancer. Using Metformin as
a cancer prevention strategy has been controversial and
results have been inconsistent, but many analysis reveals
that use of the drug is time-dependent, which may explain
the disparity. Currently, doubt still remains whether the
anti-cancer effects of Metformin observed in
in vitro
and in
vivo studies will ultimately translate into clinical benefits in
the ongoing clinical trials. While whether Metformin has a
clinically-relevant chemo preventive or anti-cancer effect is
not clear at present, the evidence from the ongoing human
clinical trial studies will help to answer this critical issue.
Biography
Mahir Kh I Jallo is a Faculty in the Canadian Academy of Natural Health and Clinical
Professor of Medicine and Consultant Endocrinologist in Gulf Medical University – UAE.
He has granted his MB, ChB fromMosul Medical College in Iraq, his postgraduate Board
Certification in Internal Medicine CABM from the Arab Board, his Fellowship of Amer-
ican College of Endocrinology FACE. He joined the JCI Accredited Thumbay Hospital
in 2004 establishing the Diabetes and Endocrinology unit. He is an active participant
and speaker in many national and international conferences and CME programs and
organizer of the annual GMU diabetes and endocrinology conference since 2012. He
is the Editor In Chief: diabetes digest from Iraq, Editorial Board Member and reviewer
for many international diabetes and endocrinology journals, with many publications in
medical periodicals and medical conferences abstract. He is active Principle Investiga-
tor in many National and International Clinical studies and Member of many national
and international medical societies and associations..
mahirjallo@hotmail.comMahir Kh I Jallo
Gulf Medical University, UAE
Metformin and the prevention of cancer... Where is the position in 2017?