There seems to be no end to the health risks associated with diabetes, a truly insidious disease that can lead to other serious health problems. Having diabetes increases risk for cardiovascular disease, kidney failure, hypertension, stroke and damage to the nerves and eyes. Recent research has also linked diabetes to a greater risk of certain cancers, including colorectal (colon or rectum) cancer. And now a study from Washington University in St. Louis concludes that diabetic women are at greater risk for developing colorectal adenomas-polyps that can tum into cancer. This is especially true for diabetic women who are also obese, defined in this study as having a body mass index of over 30.

The study compared the colonoscopy records of 100 women with type 2 diabetes with those of 500 non-diabetic women to evaluate the rate of adenomas in these women.

The results: Diabetic women had a significantly higher rate of adenomas compared with those who did not have the disease-37% versus 24%. Furthermore, women with type 2 diabetes were also more apt to have advanced adenomas-14% versus 6%. Apparently, at greatest risk of all are women who are obese and have diabetes. In fact, when compared with non-obese, non-diabetic women, these women faced nearly twice as high a risk of having any kind of adenoma and more than two times greater risk for having advanced adenoma.

We spoke with the study's lead author, Jill E. Elwing, MD, about these results. She explains that insulin is in itself a growth factor and that might be what is behind the link between diabetes and colorectal adenoma-the growth factor could produce a pro-cancerous effect. The immediate take-away from this study, she says, is that medical professionals and this group of vulnerable women should have greater awareness and pay more attention to regular screening. Women of any age who have type 2 diabetes should discuss a colorectal screening schedule with their doctors. And because being over age 50 is also considered a risk factor for colorectal cancer, diabetic women over that age should be particularly careful to follow their doctor's advice about regular screenings, she says.

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