title: The impact of type 2 diabetes mellitus on mortality in hospitalized female cancer patients in Taiwan.
abstract: BACKGROUND
  The goal of this study was to determine the relationships among type 2 diabetes mellitus (DM), specific cancer histological types and mortality in hospitalized women.
  
  
  METHODS
  Patients over 19 years of age were included if the indication for hospital admission was a diagnosis of type 2 DM or a malignancy. In total, 67,660 female patients with a mean age 62.76 ± 14.48 years were enrolled. These patients were categorized into the following three groups: patients with cancer but without type 2 DM (group A); patients with cancer and type 2 DM (group B) and patients with type 2 DM but without cancer (group C). Attributable fractions (AF) were calculated as ([hazard ratio - 1]/hazard ratio) × 100 to evaluate the impact of type 2 DM on mortality for specific cancers.
  
  
  RESULTS
  Of the study participants, 37,204 (55%) were diagnosed with type 2 DM. The patients were categorized as follows: group A, 30,456 patients; group B, 5992 patients and group C, 31,212 patients. Group B patients had high frequencies of pancreatic, liver and renal cancers and low frequencies of thyroid, breast and ovarian cancers. Of the 36,448 cancer patients, 2906 (8%) died. The mortality rate in group B (10 %) was significantly higher than that in groups A and C. Type 2 DM was associated with increased mortality and AF for thyroid, nasopharyngeal, urinary tract, ovarian, breast and cervical cancers (hazard ratio over 1.50).
  
  
  CONCLUSIONS
  The incidence of type 2 DM in patients with different histological types of cancer varied widely, ranging from 8-34%. Among the cancer patients, type 2 DM had a significantly greater impact on the mortality rates of patients with cancers associated with relatively low mortality.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan.
authors.forename: Jeng-Yeou
authors.initials: JY
authors.lastname: Chen
authors.affiliation: Department of Industrial Design, Healthy Aging Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan.
authors.forename: Wen-Ko
authors.initials: WK
authors.lastname: Chiou
authors.affiliation: Department of Industrial Design, Healthy Aging Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan.
authors.forename: Wei-Ying
authors.initials: WY
authors.lastname: Chou
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan.
authors.forename: Jen-Der
authors.initials: JD
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000401:mortality*; D016016:Proportional Hazards Models; D013624:Taiwan / Q000453:epidemiology
keywords: cancer mortality; hepatoma; hyperinsulinemia; pancreatic cancer