Episode 20: The Diabetes / Cancer Connection

The Diabetes–Cancer Connection: What No One’s Talking About

Episode summary:
Amber Wilhoit (RD/LD, CDCES) and Richie Wilhoit (TRS-C) unpack the diabetes cancer connection in clear, simple language. We look at why type 2 diabetes and cancer often show up together, what’s happening inside the body, and what you can do this week to lower risk. Amber also shares highlights from her recent talk for the Florida Society of Clinical Oncology, focused on Veterans living with cancer.

What you’ll learn:

• The diabetes cancer connection in plain English
• Why people with type 2 diabetes have a 20–25% higher risk of certain cancers (liver, pancreatic, endometrial, colorectal, breast, bladder)
• How insulin, insulin resistance, and inflammation can drive cancer growth
• What hyperinsulinemia and IGF-1 do in the body
• How oxidative stress damages DNA and why that matters
• Why “normal labs” can be misleading early on
• The real role of Metformin in cancer risk (with data)
• Why processed meat is a problem and what to swap instead
• Simple steps to lower risk for both diabetes and cancer

Key takeaways:

• It’s not just “high blood sugar.” The diabetes cancer connection is about a whole-body metabolic storm: insulin resistance, high insulin, chronic inflammation, and oxidative stress.
• When insulin stays high for a long time (hyperinsulinemia), it acts like a growth signal. That can help damaged cells survive and multiply when they should die (apoptosis).
• Chronic, low-grade inflammation (think IL-6, TNF-alpha) and oxidative stress from high glucose can damage DNA and set the stage for cancer.
• Veterans are hit hard by type 2 diabetes and cancer risk. Age plays a role, but metabolic health does too.
• Obesity is not the whole story. A meta-analysis showed higher cancer incidence and mortality in people with type 2 diabetes independent of obesity.
• Metformin stands out. Studies show:
  • 54% lower pancreatic cancer risk among Metformin users (Lancet Oncology)
  • 30% lower cancer-related death rate in people with diabetes taking Metformin (systematic review)
  • Likely mechanisms: lower insulin and activation of AMPK (the body’s energy sensor)
• Ultra-processed foods raise risk. A 10% increase in ultra-processed food intake was linked to a 12% higher overall cancer risk (BMJ, 2018).
• “Normal” tests can miss early problems. Insulin resistance starts years before a diabetes diagnosis—and risk rises early, too.

Food and lifestyle that help:

• Eat the rainbow:
  • Cruciferous veggies (broccoli, cauliflower, Brussels sprouts, cabbage) are rich in sulforaphane. This compound supports detox enzymes, lowers inflammation, and helps damaged cells die on time.
  • Mix colors for different phytonutrients: orange (carotenoids), blue/purple (anthocyanins), reds/greens (varied flavonoids).
• Fiber is your friend:
  • Aim for 30–50 grams daily. Men: ~36g minimum; women: 25g minimum (more is great).
  • Fiber supports gut health, binds excess estrogen, lowers inflammation, and steadies glucose.
  • Beans are a power food. They add fiber, support healthy gut bugs (bacteroidetes), and contain saponins that may inhibit tumor growth and boost immune function.
• Choose less-processed proteins:
  • American Institute for Cancer Research: avoid processed meats (group 1 carcinogen). Limit red meat.
  • Better swaps: beans, lentils, tofu, tempeh, fish, poultry, and plant-forward options. Some plant-based burgers can be a “less-bad” choice—check ingredients.
• Move most days:
  • Goal: 150 minutes per week (AICR). Easy start: walk 2 miles a day (can split morning/evening), especially after meals to blunt glucose spikes.
• Sleep and stress:
  • Aim for 7–9 hours per night. Reduce late-night screens, practice breath work, join a support group, and manage daily stressors.
• Reduce extra exposures:
  • Use glass instead of plastic when heating food. Be mindful of microplastics and heavy metals (choose seafood wisely).

Medication mindset:

• Meds can be a helpful “crutch” while you rebuild habits. Don’t stop cold turkey.
• If you’re on Metformin and working toward remission, great. Once blood sugars are steady, talk with your clinician about next steps.

Common pitfalls we see:

• Trusting “normal labs” while symptoms persist
• Thinking “my A1C is only 6.3, so I’m fine”
• Relying on “diabetic friendly” labels on ultra-processed foods
• Underestimating years of quiet insulin resistance before diagnosis
• Tying food choices to events/emotions without a plan for better swaps

Action plan for this week:

• Add one half-cup of beans to your day. That’s it. Sprinkle on s