Metformin

A new study conducted by researchers at Case Western Reserve University School of Medicine, Ohio, has revealed that patients living with type 2 diabetes (T2D) treated with semaglutide are less likely to develop certain cancers. The research published in JAMA Network Open revealed that patients taking semaglutide, marketed under brand names including Ozempic and Wegovy, or glucagon-like peptide-1 receptor antagonists (GLP-1 RAs) had a decreased risk of developing ten of the 13 obesity-linked cancers, including gallbladder and kidney cancer. Researchers analysed the medical records of 1.6 million T2D patients who were either on GLP-1 medicines, insulin or metmorfim between March 2005 and November 2018, who had no previous history of obesity-related cancers. The team found that patients who received GLP-1 treatment had significantly reduced risks of certain cancers, including gallbladder cancer by 65%, meningioma (63%), pancreatic cancer (59%), hepatocellular carcinoma (53%), ovarian cancer (48%), and more. However, semaglutide was not linked to a significantly reduced risk of developing thyroid, stomach or breast cancer, and the team found no significant decrease in cancer risk associated with GLP-1 RAs when compared with metformin. Yoni Resnick, director of pharmacy clinical services, New England Cancer Specialists, said: “By offering this type of weight reduction medication as compared to other types of medications… you’re reducing the risk for cancer, thus improving the overall health of the population [and] cutting healthcare costs.” Researchers intend to conduct more research, including pre-clinical and clinical trials, to build on these findings. As well as cancer, diabetes drugs have also demonstrated benefits in reducing the risk of major adverse cardiovascular events (MACE) in patients with T2D, including stroke and heart disease. In 2020, new labelling for Novo Nordisk’s Ozempic (semaglutide) was approved by the US Food and Drug Administration to indicate that it could reduce the risk of MACE in T2D patients with heart disease. Additionally, earlier this year, Sanofi’s diabetes drug Lyxumia (lixisenatide) showed potential in slowing down the progression of Parkinson’s disease based on results from a phase 2 trial co-funded by Cure Parkinson’s, the US Van Andel Institute and the French Ministry of Health.

As a globally acclaimed medication, semaglutide has been making waves with its exceptional therapeutic effects. Not only has it demonstrated remarkable performance in diabetes treatment, but it has also successfully expanded its reach to areas like weight management, cardiovascular diseases, and kidney disorders.   Recently, JAMA Oncology, a subsidiary journal of the American Medical Association, published a compelling study that unveiled the potential of GLP-1 drugs like Ozempic and Wegovy to lower the risk of up to 10 types of cancer. This finding undoubtedly brings a new glimmer of hope to the field of cancer prevention.   The logic behind GLP-1 drugs' ability to reduce the risk of malignant cancers is not overly complex. It is well-known that overweight or obese individuals have a higher risk of developing cancer, and this risk further increases with the rise in body weight and the prolonged duration of being overweight. Semaglutide, through its unique mechanism of delaying gastric emptying, suppressing appetite, and enhancing feelings of satiety and fullness, helps patients achieve weight loss.   According to data from the Centers for Disease Control and Prevention (CDC), being overweight is closely linked to a series of physiological changes, such as chronic inflammation and abnormal elevations in insulin, insulin-like growth factors, and sex hormones, all of which are potential cancer-promoting factors. The CDC also points out that around 40% of new cancer diagnoses are associated with being overweight, with 13 types of human malignant tumors already established as obesity-related.   Recent analysis of a large electronic health record (EHR) dataset by researchers at Case Western Reserve University in the United States has yielded an exciting conclusion. They found that among patients with type 2 diabetes receiving GLP-1 drug treatment, the risk of developing 10 out of the 13 mentioned malignant cancers was significantly lower compared to those solely receiving insulin therapy. This discovery encompasses a wide range of common cancer types, including esophageal, colorectal, endometrial, gallbladder, kidney, liver, ovarian, and pancreatic cancers, as well as meningioma and multiple myeloma.   Interestingly, while the risks of breast cancer, thyroid cancer, and gastric cancer did not show statistically significant differences, the study revealed that GLP-1 therapy may help reduce the risk of postmenopausal breast cancer. This finding is particularly noteworthy, as postmenopausal breast cancer is one of the cancer types most closely linked to obesity.   However, semaglutide is not without its flaws. Although it can lower the risk of various malignant cancers, it may also increase the risk of certain cancers. For instance, compared to diabetic patients taking metformin, those using GLP-1 drugs may face a higher risk of kidney cancer. Furthermore, based on research findings and previous reports about insulin promoting cancer growth, GLP-1 injections may be associated with an increased risk of thyroid cancer.   Recent studies on the side effects of GLP-1 drugs have also sparked controversies around semaglutide. One study suggests that the use of Novo Nordisk's semaglutide injection may increase the risk of a rare eye disease called non-arteritic anterior ischemic optic neuropathy (NAION), a serious eye condition that can lead to blindness. The data shows that the probability of developing NAION is four times higher in patients with type 2 diabetes using semaglutide compared to those not using the drug.   Additionally, injecting semaglutide can trigger a series of gastrointestinal symptoms, such as nausea, diarrhea, vomiting, constipation, abdominal pain, bloating, and indigestion. These issues not only impact the patient's quality of life but may also have negative effects on the treatment's efficacy.   On social media, the "Ozempic Face" phenomenon has also garnered widespread attention. This refers to the physical changes, such as sunken cheeks, loose skin, and sunken eyes, that occur due to rapid weight loss after semaglutide injection. These changes have raised doubts about semaglutide's "beauty-enhancing" effects. In fact, semaglutide may potentially lead to muscle loss and functional decline, which is a limitation in its weight-loss applications.   In conclusion, while semaglutide holds potential value in cancer prevention for high-risk populations, for those seeking weight loss, a combination of dietary modification and exercise may be a more stable and effective approach. As we enjoy the benefits of semaglutide, we must also remain vigilant about its potential side effects and risks.