Journal of Nutrition and Metabolism / 2011 / Article / Tab 1

Review Article

Cancer Risk in Type 2 Diabetes Mellitus: Metabolic Links and Therapeutic Considerations

Table 1

Cancer risk with oral agents and insulin therapy.
(a) Population studies of oral antidiabetic medications and cancer risk

StudyPublish year country
(study Yrs)
Increased risk (OR with 95% CI)Cancer type(s)

Evans et al. [79] case-control hospitalized patients2005 Scotland
(i) Metformin (OR 0.77)
None specified (All incidence of cancers)

Bowker et al. [80] retrospective2006 Canada
(i) SFU compared to metformin (HR 1.3, )
(ii) Insulin (HR 1.9, )
None specified (Looked specifically at cancer-related mortality and not cancer type.)

Monami et al. [81] case control2009 Italy
After >36 months of use:
(i) Acarbose (OR 0.77)
(ii) Glicazide (OR 0.40)
(iii) Glitazones (OR 1.05)
(iv) Insulin (OR 0.91)
(v) Metformin (OR 0.28)
(vi) Other SFU (OR 1.05)
(vii) Repaglinide (OR 0.87)
After >36 months of use:
(i) Glibenclamide (OR 2.62, )
GI breast
genital tract

Li et al. [64] case control hospitalized patients2009 United States
(i) Metformin (OR 0.38)
(i) Insulin (OR 4.99)
(ii) Insulin secretagogues (OR 2.52)
(iii) TZD’s (OR 1.55)
Pancreas (adenocarcinoma)

Mannucci et al. [82] case control2010 Italy
(i) Other insulin: lispro, aspart, and human insulin
(ii) Metformin
(i) ≥0.3 IU/kg/d of glargine
20 “other cancers”

(b) Meta-analyses of insulin and cancer

StudyPublish Year country (study Yrs)Total number of studiesTotal ( )Insulin analyzedIncreased risk?

Dejgaard et al. [83] Meta-analysis of randomized controlled Novo Nordisk trials Type I and Type II2009 Denmark218693Detemir NPH glargineNo
(i) Glargine and detemir had similar risk
(i) NPH had more risk than detemir

Home et al. [84] Meta-analysis of randomized controlled Sanofi Aventis trials Type I and Type II2009 United Kingdom3110,880GlargineNo

(c) Population studies of insulin and cancer risk

StudyPublish year country
(study Yrs)
Total ( )Insulin analyzedIncreased risk?

Yang et al. [85] retrospective cohort2004 United Kingdom (1987–2002)24,918Insulin analogues (types not specified)Yes
colorectal cancer
Donadon et al. [86] case control2008 Italy (1994–2006)955Insulin analogues (types not specified)Yes
hepatocellular cancer in insulin-treated males

Hemkens et al. [87] retrospective cohort2009 German (1998–2005)127,031Aspart, glargine, human insulin, lisproYes
may be dose dependent

Jonasson et al. [88] retrospective cohort2009 Sweden (2005–2007)114,841GlargineNo

Colhoun et al. [89] retrospective cohort2009 Scotland (2002–2005)36,254GlargineNo

Currie et al. [90] retrospective cohort2009 United Kingdom
62,809Insulin analogues (types not specified) oral agentsNo

Rosenstock et al. [91] randomized control2009 United States (5 years)1017NPH, glargineNo

Yang et al. [22] retrospective cohort2010 Hong Kong (1996–2005)4623Insulin analogues (types not specified)No

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