title: High rate of neoplasia and other co-morbid conditions in type-2 diabetic patients with longer duration of disease and poor metabolic control.
abstract: OBJECTIVE
  The aim of the study was to assess the rate of neuroendocrine malignancies in the gastrointestinal tract, other malignancies and mitotic processes, in type-2 diabetic patients. In particular, we tested the hypothesis that a poor metabolic control is associated with a higher rate of neoplasms and other co-morbid conditions, such as hypertension and peripheral neuropathy.
  
  
  METHODS
  Forty-one consecutive asymptomatic type-2 diabetic outpatients were followed for 8 years and clustered in 2 groups, according to disease duration, insulin need, and dose of oral antidiabetic agents. Physical examination, blood pressure measurements, and neurophysiologic studies were serially performed during the follow-up. In each subject, a general biochemistry was performed, aspecific and specific antigens (alpha-fetoprotein, carcinoembrionic-antigen and prostate specific antigen PSA and F-PSA) levels were measured, and invasive and non-invasive procedures were carried out, when necessary, to detect a neoplastic process.
  
  
  RESULTS
  The rate of malignancies and mitotic processes was significantly higher in patients with longer duration of disease and poor diabetes control (72% vs 13%, p=0.02). Hypertension (83% vs 54%) and peripheral neuropathy (67% vs 21%) were also more common in this group.
  
  
  CONCLUSIONS
  These data, although obtained in a relatively small population, highlight the importance of closely monitoring type-2 diabetic patients with poor diabetes control as this might be associated with the presence of malignancy or other co-morbid conditions. This may be particularly true when the poor glycemic control is characterised by a sudden onset or significant worsening despite streghtening of antidiabetic therapy.
authors.affiliation: Department of Internal Medicine, IRCCS Polyclinic, University of Milan, Milan, Italy.
authors.forename: E A
authors.initials: EA
authors.lastname: Jarmuzewska
authors.forename: C
authors.initials: C
authors.lastname: Cerri
authors.forename: A
authors.initials: A
authors.lastname: Ghidoni
authors.forename: A A
authors.initials: AA
authors.lastname: Mangoni
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology*; D013997:Time Factors