Antidiabetic medications use and cancer risk in type 2 diabetes

Dąbrowski, Mariusz; Szymańska‐Garbacz, Elektra; Miszczyszyn, Zofia; Dereziński, Tadeusz; Czupryniak, Leszek

doi:10.5603/dk.2017.0004

Cited by 5 publications

(7 citation statements)

References 30 publications

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“…In contrast to metformin, the property of SUD to stimulate insulin synthesis by β -cells of the pancreas explains the possible prooncogenic effect of these drugs through the effects of hyperinsulinemia and the activation of signaling pathways involved in carcinogenesis. The studies have proven this effect [12,16].…”

Section: Resultsmentioning

confidence: 85%

“…SUD currently dominate among second-line drugs for the treatment of patients with T2DM owing to their affordability and potent hypoglycemic effect, including people with oncological diseases [10]. Studies proved the prooncogenic effect of drugs in this group due to the effects of hyperinsulinemia [11,12]. The role of iatrogenic hyperinsulinemia (as a result of insulin therapy) as a factor of oncogenesis has been proven in many studies [13], but the results of some studies differ [14].…”

Section: Problem Statement and Analysis Of The Latest Researchmentioning

confidence: 99%

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Study of the Association Between Antihyperglycemic Therapy and Cancer in Patients with Type 2 Diabetes Mellitus

et al. 2020

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The objective of the research was to investigate the features and association of antihyperglycemic therapy and cancer in patients with type 2 diabetes mellitus. Materials and Methods. The study included the analysis of medical records of patients with type 2 diabetes mellitus who were diagnosed with cancer during 2012-2016. The obtained results were processed by statistical methods using the software packages Microsoft Excel and Statistika-12. The significance of differences between the frequency of using different treatment schemes was assessed by the Pearson’s test (χ²). To determine the risk of predicted events, the odds ratio, the 95% confidence interval, the positive and negative prognostic values were calculated. Results. There were diagnosed 533 cases of cancer in patients with type 2 diabetes mellitus. The most common scheme of antihyperglycemic therapy prior to the detection of malignant diseases was a combination of metformin and sulfonylurea derivatives (35.65%), as well as monotherapy with sulfonylurea derivatives (17.26%) and metformin (11.28%). Prior to diagnosing cancer in 396 (74.30%) patients, antihyperglycemic therapyalong with sulfonylurea derivatives and insulin was used. Among obese patients 68.82% used sulfonylureas and insulin as part of antidiabetic therapy before diagnosis of cancer. The connection between insulin therapy and the risk of cancer development in patients with type 2 diabetes mellitus was proved (the odds ratio=2.35; the 95% confidence interval (1.91 - 2.91); p<0.001). Conclusions. Prior to the detection of cancer in patients with type 2 diabetes mellitus, the combination therapy with metformin and sulfonylurea derivatives was most often used. The association between insulin therapy and the development of cancer in patients with type 2 diabetes mellitus was revealed. Cancer screening is advisable for patients with type 2 diabetes mellitus and obesity, who receive as a therapy sulfonylurea derivates and/or insulin.

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Section: Resultsmentioning

confidence: 85%

Section: Problem Statement and Analysis Of The Latest Researchmentioning

confidence: 99%

Study of the Association Between Antihyperglycemic Therapy and Cancer in Patients with Type 2 Diabetes Mellitus

et al. 2020

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“…For example, based on clinical observations and the known molecular mechanisms of insulin action, the benefits and risks of initiating and continuing insulin therapy in terms of cancer risk should always be considered. In addition, surely, heroic doses of insulin should be avoided [ 89 , 90 , 91 , 92 , 93 , 94 ]. The same applies to glitazones (in the Polish market only pioglitazone remained in use).…”

Section: Discussionmentioning

confidence: 99%

“…Insulin monotherapy was associated with elevated risk of cancer incidence in a dose-dependent manner in a study by Holden et al [ 92 ]. Own study also showed elevated risk of cancer associated with insulin monotherapy, but it was attenuated to insignificant level when insulin was combined with metformin [ 93 ]. On the other hand, in prospective, randomized clinical trial (RCT), Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial, elevated cancer risk among insulin users has not been found [ 94 ].…”

Section: Antidiabetic Medications and Cancermentioning

confidence: 99%

Diabetes, Antidiabetic Medications and Cancer Risk in Type 2 Diabetes: Focus on SGLT-2 Inhibitors

Dąbrowski

2021

IJMS

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In the last decade, cancer became the leading cause of death in the population under 65 in the European Union. Diabetes is also considered as a factor increasing risk of cancer incidence and mortality. Type 2 diabetes is frequently associated with being overweight and obese, which also plays a role in malignancy. Among biological mechanisms linking diabetes and obesity with cancer hyperglycemia, hyperinsulinemia, insulin resistance, increased levels of growth factors, steroid and peptide hormones, oxidative stress and increased activity of pro-inflammatory cytokines are listed. Antidiabetic medications can modulate cancer risk through directly impacting metabolism of cancer cells as well as indirectly through impact on risk factors of malignancy. Some of them are considered beneficial (metformin and thiazolidinedions—with the exception of bladder cancer); on the other hand, excess of exogenous insulin may be potentially harmful, while other medications seem to have neutral impact on cancer risk. Inhibitors of the sodium-glucose cotransporter-2 (SGLT-2) are increasingly used in the treatment of type 2 diabetes. However, their association with cancer risk is unclear. The aim of this review was to analyze the anticancer potential of this class of drugs, as well as risks of site-specific malignancies associated with their use.

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“…A lot of studies have shown an increased risk of cancer in patients who undergo sulfonylurea (SU) therapy due to its ability to stimulate insulin release, leading to hyperinsulinemia [5]. However, some studies prove the potential oncoprotective properties of SU derivatives related to their mechanism of action, in particular through their ability to suppress VEGF and neovascularization of malignant neoplasms (MN), reduce tumor necrosis factor-α (TNF-α) levels and the amount of receptors for TNF-α in cancer cells (affecting tumor microenvironment), and due to their antioxidant effects [6].…”

Section: Introductionmentioning

confidence: 99%

Colorectal cancer and pancreatic cancer in patients with type 2 diabetes mellitus. Study of the effect of insulin therapy

Вацеба¹,

Соколова²,

Pushkarev³

2020

CE&ES

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Antidiabetic medications use and cancer risk in type 2 diabetes

Cited by 5 publications

References 30 publications

Study of the Association Between Antihyperglycemic Therapy and Cancer in Patients with Type 2 Diabetes Mellitus

Study of the Association Between Antihyperglycemic Therapy and Cancer in Patients with Type 2 Diabetes Mellitus

Diabetes, Antidiabetic Medications and Cancer Risk in Type 2 Diabetes: Focus on SGLT-2 Inhibitors

Colorectal cancer and pancreatic cancer in patients with type 2 diabetes mellitus. Study of the effect of insulin therapy

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