en Pediatric Hematology & Oncology Pediatric Hematology & Oncology مقاله مروری Review Article <div style="border-bottom: 1pt solid windowtext; padding: 0in 0in 1pt; text-align: justify;"><span style="line-height:2;"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><strong>Background: </strong>Childhood diabetes and cancer have traditionally been viewed as distinct disorders; however, accumulating evidence indicates substantial biological overlap through shared genetic, metabolic, inflammatory, and endocrine pathways. The increasing prevalence of childhood obesity and type 2 diabetes (T2D), together with improved survival among pediatric cancer patients, has intensified interest in the bidirectional relationship between these conditions.<br> <strong>Objective:</strong> To review current evidence regarding the interplay between diabetes and childhood cancer, with particular emphasis on genetic predisposition syndromes, obesity, insulin resistance, metabolic dysregulation, treatment-related diabetes, and survivorship outcomes.<br> <strong>Methods: </strong>A comprehensive narrative review of the literature was conducted using major medical databases, including PubMed, Scopus, Embase, and Cochrane Library. Relevant studies addressing childhood diabetes, pediatric malignancies, cancer predisposition syndromes, obesity, insulin resistance, endocrine late effects, and survivorship care were evaluated and synthesized.<br> <strong>Results:</strong> Emerging evidence demonstrates that obesity, insulin resistance, hyperinsulinemia, chronic inflammation, oxidative stress, and dysregulated insulin-like growth factor-1 (IGF-1) signaling contribute to both metabolic disease and tumorigenesis. Several hereditary cancer predisposition syndromes, including Li&ndash;Fraumeni syndrome, Beckwith&ndash;Wiedemann syndrome, Constitutional Mismatch Repair Deficiency, Neurofibromatosis type 1, Fanconi anemia, and PTEN hamartoma tumor syndrome, further illustrate the intersection between cancer susceptibility and metabolic dysfunction. Conversely, childhood cancer survivors are at increased risk of developing diabetes because of chemotherapy, corticosteroid exposure, radiotherapy, hematopoietic stem cell transplantation, endocrine organ injury, altered body composition, and persistent inflammation. These metabolic abnormalities may adversely affect treatment response, long-term morbidity, cardiovascular risk, and quality of life.<br> <strong>Conclusions: </strong>Diabetes and childhood cancer are interconnected through complex genetic and metabolic mechanisms. Recognition of shared pathways and cancer predisposition syndromes may facilitate earlier diagnosis, individualized surveillance, and targeted preventive strategies. Integrating pediatric oncology, endocrinology, genetics, nutrition, and lifestyle interventions is essential to optimize long-term outcomes and survivorship care in this vulnerable population.</span></span></span></div> Childhood cancer , Diabetes mellitus , Childhood obesity , Metabolic syndrome , Cancer predisposition syndrome , Insulin resistance, Pediatric oncology, Endocrine late effects 56 69 http://ijbc.ir/browse.php?a_code=A-10-190-30&slc_lang=en&sid=1 Babak Abdolkarimi 100319475328460013359 100319475328460013359 No Hakim children hospital, Tehran University of Medical Science, Tehran, Iran. Rana Doroudian Dr.doroudian@gmail.com 100319475328460013360 100319475328460013360 Yes Hakim children hospital, Tehran University of Medical Science, Tehran, Iran. Niki Panahi 100319475328460013361 100319475328460013361 No Azad University, Tehran, Iran. Elahe Rahmati 100319475328460013362 100319475328460013362 No Department of Healthcare Services Management, School of Health Management & Information Sciences, Iran University of Medical Sciences, Tehran, Iran.