DISEASE OF THE FEMALE REPRODUCTIVE SYSTEM, WHICH MANIFESTS ITSELF WITH DIABETES MELLITUS TYPE 2

Abstract

Relevance: Epidemiological studies have shown that cancer of the female
reproductive system, including endometrial and ovarian cancers, is more common in
people with diabetes. One of the meta-analyses showed a statistically significant
association of DM2 with the risk of endometrial cancer (total relative risk (HR) 2.10;
95% confidence interval (CI) 1.75-2.53). This meta-analysis also talks about the
relationship between DM1 and endometrial cancer (total HR 3.15; 95% CI 1.07-9.29).
It should be noted that many studies provide evidence in favor of the fact that the
incidence of cancer of the ovaries, esophagus, endometrium, vulva and vagina, thyroid
gland is higher among women with DM1. On the other hand, patients with DM1 have
a lower risk of developing breast cancer, melanoma and Hodgkin's lymphoma. Cells
of most types of malignant neoplasms predominantly express the type 1 glucose
transporter, which has a high affinity for glucose. It is also worth mentioning the
Warburg effect, in which glucose in tumor cells follows an energetically inefficient
glycolysis pathway with a high level of lactate production. Increased glycolysis in
tumor cells provides the materials necessary for the synthesis of nucleotides, amino
acids and lipids. In addition, hyperglycemia is responsible for DNA damage, which is
the first stage of oncogenesis. For endometrial cancer, it has been suggested that in
precancerous conditions or an existing tumor disease, endometrial cells, as well as
microenvironment cells, can use excess glucose to stimulate anabolic pathways and
disease progression. The genetic features of endometrial cancer indicate that most of
these tumors already have a predisposition to increased glucose metabolism due to loss
of expression. In DM2, insulin resistance leads to the development of compensatory
hyperinsulinemia. High concentration of insulin in the blood plays one of the key roles
in the pathogenesis of malignant neoplasms, which has been demonstrated in numerous
studies both in vitro and in vivo.