Diabetes and cancer: clinical implications for integrated metabolic–oncologic care

Diabetes mellitus and cancer are among the most prevalent non-communicable diseases worldwide and increasingly coexist in clinical practice. Epidemiological evidence indicates that type 2 diabetes is associated with elevated risk of several malignancies, including hepatocellular, pancreatic, colorectal, endometrial, and breast cancers. At the same time, cancer and its treatments may significantly disrupt metabolic homeostasis and complicate glycemic control. Therapies such as glucocorticoids, PI3K inhibitors, and immune checkpoint inhibitors can induce hyperglycemia or precipitate new-onset diabetes. Metabolic dysregulation during cancer therapy has been associated with increased infection risk, treatment complications, and adverse clinical outcomes. This review summarizes the epidemiological evidence linking diabetes and cancer and discusses the clinical implications of their bidirectional interaction. The growing coexistence of both conditions highlights the need for integrated metabolic-oncologic care. Proactive glycemic monitoring, individualized antidiabetic therapy selection, and multidisciplinary management may improve treatment tolerance and long-term outcomes in patients with cancer and diabetes.