title: Impact of glucose-lowering agents on the risk of cancer in type 2 diabetic patients. The Barcelona case-control study.
abstract: BACKGROUND
  The aim of the present study is to evaluate the impact of glucose-lowering agents in the risk of cancer in a large type 2 diabetic population.
  
  
  METHODS
  A nested case-control study was conducted within a defined cohort (275,164 type 2 diabetic patients attending 16 Primary Health Care Centers of Barcelona). Cases (n = 1,040) comprised those subjects with any cancer diagnosed between 2008 and 2010, registered at the Cancer Registry of Hospital Vall d'Hebron (Barcelona). Three control subjects for each case (n = 3,120) were matched by age, sex, diabetes duration, and geographical area. The treatments analyzed (within 3 years prior to cancer diagnosis) were: insulin glargine, insulin detemir, human insulin, fast-acting insulin and analogues, metformin, sulfonylureas, repaglinide, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, and alpha glucosidase inhibitors. Conditional logistic regressions were used to calculate the risk of cancer associated with the use of each drug adjusted by age, BMI, dose and duration of treatment, alcohol use, smoking habit, and diabetes duration.
  
  
  RESULTS
  No differences were observed between case and control subjects for the proportion, dose or duration of exposure to each treatment. None of the types of insulin and oral agents analyzed showed a significant increase in the risk of cancer. Moreover, no cancer risk was observed when glargine was used alone or in combination with metformin.
  
  
  CONCLUSIONS
  Our results suggest that diabetes treatment does not influence the risk of cancer associated with type 2 diabetes. Therefore, an eventual increase of cancer should not be a reason for biasing the selection of any glucose-lowering treatment in type 2 diabetic population.
authors.affiliation: Grup de Recerca en Diabetis i Metabolisme i CIBER de Diabetis i Malalties Metabòliques Associades (CIBERDEM), Institut de Recerca Hospital Vall d'Hebron, Barcelona, Spain ; Universitat Autònoma de Barcelona, Bellaterra, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Simó
authors.forename: Oleguer
authors.initials: O
authors.lastname: Plana-Ripoll
authors.forename: Diana
authors.initials: D
authors.lastname: Puente
authors.forename: Rosa
authors.initials: R
authors.lastname: Morros
authors.forename: Xavier
authors.initials: X
authors.lastname: Mundet
authors.forename: Luz M
authors.initials: LM
authors.lastname: Vilca
authors.forename: Cristina
authors.initials: C
authors.lastname: Hernández
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Fuentes
authors.forename: Adriana
authors.initials: A
authors.lastname: Procupet
authors.forename: Josep M
authors.initials: JM
authors.lastname: Tabernero
authors.forename: Concepción
authors.initials: C
authors.lastname: Violán
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D013030:Spain / Q000453:epidemiology
chemical_list: D007004:Hypoglycemic Agents