title: Does insulin glargine increase the risk of cancer compared with other basal insulins?: A French nationwide cohort study based on national administrative databases.
abstract: OBJECTIVE
  To explore in France the relationship between insulin glargine use and overall and specific cancer risks in type 2 diabetic patients compared with other basal insulins.
  
  
  METHODS
  Data were extracted from French health insurance information system (Système National d'Information Inter-Régimes de l'Assurance Maladie) linked with data from the French Hospital Discharge database (Programme de Médicalisation des Systèmes d'Information). Included were 70,027 patients aged 40-79 years who started a basal insulin in 2007-2009. Cox proportional hazards models with age as time-scale were used to calculate multivariate-adjusted hazard ratios for associations between type of basal insulin and risk of overall cancer, breast cancer, and seven other cancer sites.
  
  
  RESULTS
  The median follow-up was 2.67 years in patients exposed to insulin glargine. Absolute event rates for all cancer in patients exposed to glargine versus other basal insulin users were 1,622 and 1,643 per 100,000 person-years, respectively. No significant association was observed between glargine exposure and overall cancer incidence after adjustment for sex, with a hazard ratio of 0.97 (95% CI 0.87-1.07), or after additional adjustment for any other hypoglycemic agent use and duration of diabetes. No increased risk of breast cancer was observed for glargine users compared with other basal insulins users, with a fully adjusted hazard ratio of 1.08 (0.72-1.62).
  
  
  CONCLUSIONS
  In a large cohort of patients newly treated by basal insulin, no increased risk of any cancer was observed in insulin glargine users compared with other basal insulin users. Because follow-up did not exceed 4 years, longer-term studies are needed.
authors.affiliation: Strategy and Research Department, National Health Insurance, Paris, Ile de France, France. jean-paul.fagot@cnamts.fr
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Fagot
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Blotière
authors.forename: Philippe
authors.initials: P
authors.lastname: Ricordeau
authors.forename: Alain
authors.initials: A
authors.lastname: Weill
authors.forename: François
authors.initials: F
authors.lastname: Alla
authors.forename: Hubert
authors.initials: H
authors.lastname: Allemand
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D005602:France; D006801:Humans; D007328:Insulin / Q000009:adverse effects*; D000069057:Insulin Detemir; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology*
chemical_list: D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; D000069057:Insulin Detemir