Published online Mar 21, 2025. doi: 10.3748/wjg.v31.i11.104065
Revised: January 16, 2025
Accepted: February 17, 2025
Published online: March 21, 2025
Processing time: 94 Days and 19.2 Hours
Type 2 diabetes mellitus (T2DM) significantly elevates the risk of colorectal cancer (CRC) and complicates its treatment by promoting chemoresistance. Poor glycemic control has been linked to exacerbated CRC progression and diminished chemotherapy efficacy, impacting patient outcomes through various mechanisms such as oxidative stress, activation of metabolic pathways, and altered protein modifications that hinder apoptosis and enhance tumor survival. Clinical evidence shows that T2DM patients experience higher rates of chemoresistance and reduced disease-free survival and overall survival compared to non-diabetic patients. Specifically, those with poor glycemic control exhibit increased chemo
Core Tip: Type 2 diabetes mellitus exacerbates colorectal cancer (CRC) progression by inducing chemoresistance through mechanisms such as oxidative stress, altered metabolic pathways, and disrupted apoptotic signalling. Poor glycemic control worsens patient outcomes, reducing disease-free survival and overall survival. Antidiabetic treatments, notably metformin, show potential in enhancing chemotherapy efficacy while improving glycemic management. A multidisciplinary care model involving oncologists, endocrinologists, and surgeons is essential to mitigate chemoresistance and optimize survival outcomes in CRC patients with type 2 diabetes mellitus. Prioritizing glycemic control through integrated therapeutic strategies offers a promising avenue for improving CRC treatment success in this high-risk patient population.