title: Insulin therapy and colorectal adenoma risk among patients with Type 2 diabetes mellitus: a case-control study in Korea.
abstract: OBJECTIVE
  Patients with Type 2 diabetes mellitus may be at increased colorectal adenoma and cancer risk. Moreover, chronic insulin therapy may increase the risk of colorectal cancer among patients with Type 2 diabetes mellitus. We investigated to determine whether insulin therapy might increase the risk of colorectal adenoma among clinically confirmed patients with Type 2 diabetes mellitus.
  
  
  METHODS
  We conducted a retrospective study among patients with Type 2 diabetes mellitus who underwent total colonoscopy between January 2003 and July 2006 at Hallym University Sacred Heart Hospital. Among them (n = 325), patients with histologically confirmed colorectal adenomas (n = 100) and the same number of controls matched by age and sex were selected and analyzed.
  
  
  RESULTS
  Adenoma cases showed significantly higher rate of chronic insulin therapy (more than 1 year) than controls (P = 0.018). In multivariate regression analysis, patients who received chronic insulin therapy had three times the risk of colorectal adenoma compared with patients who received no insulin (odds ratio, 3; 95 percent confidence interval, 1.1-8.9; P = 0.04).
  
  
  CONCLUSIONS
  Chronic insulin therapy was associated with increased colorectal adenoma risk among Type 2 diabetes mellitus patients. This result may provide a need for more intensive colorectal cancer screening program in patients with Type 2 diabetes mellitus, especially those who receive chronic insulin therapy.
authors.affiliation: Department of Gastroenterology, Hallym University Sacred Heart Hospital, Anyang, South Korea.
authors.forename: Yong Woo
authors.initials: YW
authors.lastname: Chung
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Han
authors.forename: Kwang Hyuk
authors.initials: KH
authors.lastname: Park
authors.forename: Chang Soo
authors.initials: CS
authors.lastname: Eun
authors.forename: Kyo-Sang
authors.initials: KS
authors.lastname: Yoo
authors.forename: Choong Kee
authors.initials: CK
authors.lastname: Park
mesh_terms: D000236:Adenoma / Q000139:chemically induced* / Q000453:epidemiology; D000368:Aged; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007328:Insulin / Q000009:adverse effects*; D007723:Korea / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk
chemical_list: D007328:Insulin