The influence of glucose-lowering therapies on cancer risk in type 2 diabetes

摘要: Aims/hypothesis The risk of developing a range solid tumours is increased in type 2 diabetes, and may be influenced by glucose-lowering therapies. We examined the development relation to treatment with oral agents, human insulin analogues. Methods This was retrospective cohort study people treated UK general practices. Those included analysis developed diabetes >40 years age, started agents or after 2000. A total 62,809 patients were divided into four groups according whether they received monotherapy metformin sulfonylurea, combined therapy (metformin plus sulfonylurea), insulin. Insulin users grouped glargine, long-acting insulin, biphasic analogue outcome measures progression any tumour, cancer breast, colon, pancreas prostate. Confounding factors accounted for using Cox proportional hazards models. Results Metformin carried lowest cancer. In comparison, adjusted HR 1.08 (95% CI 0.96–1.21) 1.36 1.19–1.54) sulfonylurea monotherapy, 1.42 1.27–1.60) insulin-based regimens. Adding reduced (HR 0.54, 95% 0.43–0.66). Theriskforthoseonbasalhumaninsulin alone vs glargine 1.24 0.90–1.70). Compared metformin, colorectal 1.69, 1.23–2.33) pancreatic cancer(HR 4.63,95% CI2.64–8.10),but did not influencethe riskofbreastorprostatecancer.Sulfonylureaswereassociated similar pattern as Conclusions/interpretation on secretagogues more likely develop cancers than those combination abolished most this excess risk. use associated lower colon pancreas, but affect breast prostate Use analogues compared