A ground-breaking study has uncovered an alarming link between two of the most common chronic conditions worldwide—type 2 diabetes and breast cancer.
Researchers from Boston University’s Chobanian and Avedisian School of Medicine have found that type-2 diabetes, particularly when driven by obesity, can make breast cancer more aggressive. The study, published in Springer Nature, shows that microscopic blood particles called exosomes undergo significant changes in diabetic individuals.
By interfering with the body's immune system, these altered exosomes produce a tumour environment that promotes cancer growth, spread, and treatment resistance.
This is the first study to show that exosomes from type 2 diabetics directly inhibit the immune system within breast tumours. While earlier research had established that women with diabetes face higher risks of breast cancer and poorer outcomes, the exact mechanism was unknown until now.
What is type 2 diabetes
Type 2 diabetes is a chronic metabolic disorder characterised by either insufficient insulin production or inefficient insulin utilisation. Over time, this raises the risk of several problems, such as kidney damage, cardiovascular disease, and—as this study demonstrates—more aggressive malignancies.
How the study was conducted
The researchers used patients' breast cancer tissue to create three-dimensional tumour organoids to test their theory. These organoids preserve natural immune cells while replicating an actual tumour environment in the lab. When exposed to diabetic exosomes, the organoids showed immune suppression. However, organoids treated with exosomes from people without diabetes maintained better immune responses.
Dr Gerald Denis, lead author and Shipley Prostate Cancer Research Professor, noted that these findings may explain why standard treatments such as immunotherapy are often less effective in diabetic patients. “If exosomes from type-2 diabetes patients suppress immune cells, treatments designed to activate the immune system may fail,” he said.
Why it matters
As type-2 diabetes continues to rise worldwide and breast cancer remains one of the most prevalent cancers among women, it is crucial to understand how the two conditions influence each other.
“Breast cancer is already challenging to treat, and people with type 2 diabetes have worse outcomes, but clinicians don’t fully understand why. Our study reveals one possible reason: diabetes changes the way the immune system works inside tumours. This could help explain why current treatments, like immunotherapy, don’t work as well in patients with diabetes. Knowing this opens the door to better, more personalised treatments for millions of people,” Denis said.
The study emphasises the value of creating personalised cancer treatments that consider a patient's immunity and metabolic state rather than depending solely on standard treatment regimens.
In the future, scientists hope to investigate whether modifying or targeting diabetic exosomes could result in new treatment approaches, which could increase survival rates and change the way diabetes patients with breast cancer are treated.
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