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Experimental Diabetes Research
Volume 2012 (2012), Article ID 413782, 6 pages
http://dx.doi.org/10.1155/2012/413782
Research Article

The Influence of Type 2 Diabetes and Glucose-Lowering Therapies on Cancer Risk in the Taiwanese

1Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
2Graduate Institute of Integrated Medicine, China Medical University, Taiwan
3Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
4School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
5Department of Internal Medicine, National Taiwan University College of Medicine, No. 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 24 February 2012; Accepted 2 April 2012

Academic Editor: Chien-Jen Chen

Copyright © 2012 Ming-Chia Hsieh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To investigate the association between type 2 diabetes, glucose-lowering therapies (monotherapy with either metformin, sulphonylurea or insulin) and cancer risk in Taiwan. Methods. Using Taiwan’s National Health Research Institutes database of 1,000,000 random subjects from 2000–2008, we found 61777 patients with type 2 diabetes (age ≥20 years) and 677378 enrollees with no record of diabetes. Results. After adjusting for age and sex, we found patients with diabetes to have significantly higher risk of all cancers (OR: 1.176; 95% CI: 1.149–1.204, 𝑃 < 0 . 0 0 1 ). Diabetic patients treated with insulin or sulfonylureas had significantly higher risk of all cancers, compared to those treated with metformin (OR: 1.583; 95% CI: 1.389–1.805, 𝑃 < 0 . 0 0 1 and OR: 1.784; 95% CI: 1.406–2.262, 𝑃 < 0 . 0 0 1 ). Metformin treatment was associated with a decreased risk of colon and liver cancer compared to sulphonylureas or insulin treatment. Sulfonylureas treatment was associated with an increased risk of breast and lung cancer compared to metformin therapy. Conclusions. Taiwanese with type 2 diabetes are at a high risk of breast, prostate, colon, lung, liver and pancreatic cancer. Those treated with insulin or sulfonylureas monotherapy are more likely to develop colon and liver cancer than those treated with metformin.