Abstract
Background: Recent evidence suggests that some hypoglycemic treatments could affect the incidence
of malignancies. This study was aimed at the assessment of cancer-related mortality
in type 2 diabetic patients treated with different hypoglycemic drugs.
Methods: A retrospective observational cohort study was performed on a consecutive series
of 3002 type 2 diabetic outpatients. Cancer-related death was identified through the
City Registry Office. For patients visited for the first time after January 1st , 2000, information on incidence of cancer was also available.
Results: During a mean follow-up of 4.3±2.5 years, 87 cases of cancer-related death were recorded,
with a yearly incidence rate of 0.70%. Patients receiving secretagogues showed a significantly
higher mortality than the rest of the sample (unadjusted OR [95%CI] 1.76 [1.15-2.69],
p=0.009), which was maintained after adjustment for confounders (HR 2.29 [1.21-4.02],
p=0.003). Conversely, no significant association of cancer-related mortality was observed
with insulin sensitizers or exogenous insulin. In comparison with patients receiving
no hypoglycemic treatment, those on secretagogue or insulin monotherapy showed a higher
cancer-related mortality (HR 2.25 [1.10-4.78], p=0.034 and HR 2.11 [1.01-4.50], p=0.048,
respectively). The effect of treatments on incidence of malignancies was similar to
that observed on cancer-related death.
Conclusions Insulin secretagogues and, to a lesser extent, exogenous insulin, appear to be associated
with increased mortality for cancer, even after adjustment for multiple confounders.
This issue deserves further investigation through epidemiological studies on larger
samples of patients.
Key words
diabetes mellitus - hypoglycemic drugs - cancer - glibenclamide
References
Correspondence
edoardo.mannucci@fastwebnet.it mmonami@libero.it
