Impact of cancer on use of glucose-lowering drug treatment in individuals with diabetes: potential mechanisms

Pouwer, Frans

doi:10.1007/s00125-015-3560-5

Cited by 3 publications

(5 citation statements)

References 8 publications

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“…As elaborated in our study [2] and in the contribution by Pouwer [1], we can conclude that the association between adherence to glucose-lowering treatment and cancer is probably explained by an interplay of factors. We thank Pouwer for his valuable additions regarding potential mechanisms to explain the complex association.…”

supporting

confidence: 73%

“…Cancer . Glucose-lowering drugs To the Editor: We thank Frans Pouwer for his comments on our study [1] exploring adherence to glucose-lowering drugs following a cancer diagnosis among individuals with diabetes [2]. Our findings revealed that there was a significant drop in the medication possession ratio at the time of cancer diagnosis, with the largest drops among patients with stage IV disease and gastrointestinal or pulmonary cancers.…”

mentioning

confidence: 85%

“…Depressive symptoms might have a role in this, since depression is related to stress and seems also to be associated with lower adherence rates, as discussed in the comment of Pouwer [1]. Consequently, it would be very relevant and interesting to investigate in a future study whether the decline in adherence was modified by the presence of depression or depressive symptoms among patients with cancer and diabetes.…”

mentioning

confidence: 96%

“…Our findings revealed that there was a significant drop in the medication possession ratio at the time of cancer diagnosis, with the largest drops among patients with stage IV disease and gastrointestinal or pulmonary cancers. In his letter, Pouwer describes two potential mechanisms that could explain these results [1].…”

mentioning

confidence: 99%

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Impact of cancer on use of glucose-lowering drug treatment in individuals with diabetes: potential mechanisms. Reply to Pouwer F [letter]

et al. 2015

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confidence: 73%

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confidence: 85%

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confidence: 96%

mentioning

confidence: 99%

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Impact of cancer on use of glucose-lowering drug treatment in individuals with diabetes: potential mechanisms. Reply to Pouwer F [letter]

et al. 2015

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“…Survival from many cancer types is steadily increasing [1]. As a result, a growing number of patients with cancer will live with other chronic diseases, of which diabetes is one of the most prevalent [2]. Besides giving rise to diabetes-related complications and death [3], type 2 diabetes in itself represents a risk factor for developing several types of cancer, e.g., pancreatic, liver, colorectal, breast, urinary tract, and female reproductive cancers [4].…”

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confidence: 99%

The impact of cancer on diabetes outcomes

et al. 2019

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Background Survival from many cancer types is steadily increasing, and as a result, a growing number of cancer patients will live with other chronic diseases, of which diabetes is one of the most prevalent. This study aims to describe the impact of cancer on health outcomes in patients with type 2 diabetes and to compare the effectiveness of a multifactorial intervention in diabetes patients with and without cancer. Methods The randomized controlled trial Diabetes Care in General Practice (DCGP) included 1381 patients newly diagnosed with type 2 diabetes. Patients were randomized to either six years of structured personal diabetes care or routine care. In a post hoc analysis, we followed patients for 19 years in Danish national registries for the occurrence of diabetes-related outcomes. We used Cox regression models to estimate hazard ratios for outcomes. Results At diagnosis 48 patients had cancer, and 243 patients were diagnosed with cancer during follow up. Patients with diabetes and cancer had excess all-cause mortality (HR 3.33; 95%CI 2.72–4.06), as well as an increased incidence of myocardial infarction (HR 1.76; 95%CI 1.29–2.39) and any diabetes-related outcome (HR 1.36; 95%CI 1.07–1.71). The intervention reduced the risk of both these endpoints in patients without cancer. Furthermore, there was no statistically significant difference in the effectiveness of the intervention among patients with and without cancer. Conclusions Diabetes patients with cancer had an increased risk of myocardial infarction and any diabetes-related outcome. The observed positive effect of structured personal diabetes care on clinical outcomes did not differ between patients with and without cancer. Attention to and prevention of diabetes complications in patients with both type 2 diabetes and cancer is warranted. Trial registration ClinicalTrials.gov NCT01074762 (February 24, 2010). Electronic supplementary material The online version of this article (10.1186/s12902-019-0377-0) contains supplementary material, which is available to authorized users.

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