The influence of type 2 diabetes and glucose-lowering therapies on cancer risk in the Taiwanese.
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 < 0.001). 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 < 0.001 and OR: 1.784; 95% CI: 1.406-2.262, P < 0.001). 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.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Ming-Chia
MC
Hsieh
Tzu-Chi
TC
Lee
Shu-Min
SM
Cheng
Shih-Te
ST
Tu
Ming-Hong
MH
Yen
Chin-Hsiao
CH
Tseng
D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000209:etiology; D016017:Odds Ratio; D012044:Regression Analysis; D012306:Risk; D012737:Sex Factors; D015398:Signal Transduction; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D013624:Taiwan
D007328:Insulin; D013453:Sulfonylurea Compounds; D008687:Metformin