Diabetes and Cancer: Evidence for Risk, Methodology and Implications

Diabetes and cancer: Doubts of a causal link

“…We now appreciate that many of these observations were based on sub-optimal analytical designs, mainly failing to account for immortal time bias, and were spurious. 1 In general, the impact of anti-diabetes medications is likely to be minimal but this question will require continual monitoring as newer drugs mature. For example, a recent 1:1 randomized controlled trial tested if Semaglutide, a GPL-1 analogue, reduced the risk of adverse cardiovascular events in obese individuals without diabetes.…”

“…A link between diabetes and cancer was noted as early as 1914, 1 but received little attention until the 2000s. Excess body fatness, a key risk factor for type 2 diabetes, is associated with at least 13 obesity‐related cancers, namely esophageal adenocarcinoma, gastric cardia, colorectal, liver, gallbladder, pancreatic, post‐menopausal breast, endometrial, ovarian, kidney renal‐cell, meningioma, thyroid and multiple myeloma 2 .…”

“…Initial reports suggested that metformin might be cancer‐protective; while long‐acting insulin analogues might increase cancer risk. We now appreciate that many of these observations were based on sub‐optimal analytical designs, mainly failing to account for immortal time bias, and were spurious 1 . In general, the impact of anti‐diabetes medications is likely to be minimal but this question will require continual monitoring as newer drugs mature.…”