The prevalence of diabetes mellitus has increased substantially over
the past several decades, in part because of the growing epidemic of obesity.1 Approximately 8% of the US population has diabetes,2 with more than 90% of cases classified as type 2 diabetes,
and with insulin resistance as the major underlying pathophysiology. Much
of the emphasis in diabetes management focuses on reducing end-organ complications,
including retinopathy, neuropathy, nephropathy, and macrovascular disease.
Several recent epidemiological studies, including the report by Jee et al3 in this issue of JAMA, have
also shown an association between diabetes and several common cancers, including
pancreas and colon cancer. How important is this effect and what are the public
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