Researchers from Peking University People’s Hospital analyzed decades of evidence to understand how these widely used drugs might alter cancer biology, revealing both new treatment opportunities and unanswered questions.
Type 2 diabetes (T2DM) has long been linked to higher risks of cancers like liver, colorectal, and breast cancer. Traditionally, this connection was thought to stem from high blood glucose, obesity, and insulin resistance. But the review highlights how diabetes itself—and the drugs used to treat it—could directly influence cancer progression through complex molecular pathways.
The researchers focused on three major drug groups: metformin, SGLT2 inhibitors, and GLP-1 receptor agonists. Drawing from human studies, laboratory experiments, and clinical databases, they found that metformin appears to have broad anti-cancer effects. It activates energy-regulating pathways such as AMPK and mTOR while reducing cancer-promoting signals through PI3K/AKT. These actions can slow tumor growth, cut off blood supply to cancer cells, and strengthen immune defenses within the tumor microenvironment.
For SGLT2 inhibitors and GLP-1 receptor agonists-newer classes of diabetes drugs-the evidence remains mixed. Some studies suggest they reduce inflammation, promote cell death (apoptosis), and may lower cancer risk. Others show no clear effect, hinting that their benefits may vary depending on drug type and cancer location. For example, metformin shows promise in preventing liver and colorectal cancers but has uncertain effects on breast cancer.
Experts like Dr. Linong Ji caution that while the emerging data are encouraging, many questions remain. The next step is long-term clinical research to confirm these effects in real-world settings. Still, the findings strengthen the case for a more personalized treatment approach—one that aligns diabetes care with cancer prevention and opens new avenues for therapy combining metabolic and oncology research.
REFERENCE: Meng Cao, Chu Lin, Xiaoling Cai, Fang Lv, Wenjia Yang, Linong Ji. Anti-diabetic medications and cancer: links beyond glycemic and body weight control. Precision Clinical Medicine, 2025; 8 (4) DOI: 10.1093/pcmedi/pbaf028
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