Patients with diabetes with and without sodium-glucose cotransporter-2 inhibitors use with incident cancer risk

Hu, Wei‐Syun; Lin, Cheng‐Li

doi:10.1016/j.jdiacomp.2023.108468

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…A recent study conducted in Taiwan reached a similar conclusion, suggesting that the duration of SGLT-2i use may be related to the risk of cancer; that study also reported that the risk of developing cancer was higher when the duration of SGLT-2i use was shorter than 140 days. 51 As stated above, the duration of drug use also influences the risk of cancer. According to the development of cancers being slow and complex, the anticancer effects of SGLT-2i are observed after prolonged use.…”

Section: Discussionmentioning

confidence: 96%

Comparison between sodium‐glucose cotransporter 2 inhibitors and dipeptidyl peptidase 4 inhibitors on the risk of incident cancer in patients with diabetes mellitus: A real‐world evidence study

Sung,

Hung,

Tung

et al. 2024

Diabetes Metabolism Res

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AimsSodium‐glucose cotransporter 2 inhibitors (SGLT‐2is) have been demonstrated to be associated with cancer cell mechanisms. However, whether they increase the risk of cancer remains unclear. Thus, this study aimed to determine the association between SGLT‐2i use and the incidence of cancer in patients with diabetes mellitus (DM) in Taiwan.Materials and MethodsThis retrospective cohort study was based on the Taiwan National Health Insurance database. The study population comprised patients with DM, and those who first used SGLT‐2is during 2016–2018 were assigned to the study group. Greedy propensity score matching was performed to select patients who first used dipeptidyl peptidase 4 inhibitors (DPP‐4is), and these patients were assigned to the control group. A Cox proportional hazards model was used to estimate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for cancer risk in the study and control groups; this model was adjusted for demographic characteristics, DM severity, comorbidities and concomitant medication use.ResultsAfter controlling for relevant variables, the SGLT‐2i cohort (aHR = 0.90, 95% CI = 0.87–0.93) had a significantly lower risk of developing cancer than the DPP‐4i cohort, particularly when the SGLT‐2i was dapagliflozin (aHR = 0.91, 95% CI = 0.87–0.95) or empagliflozin (aHR = 0.90, 95% CI = 0.86–0.94). Regarding cancer type, the SGLT‐2i cohort's risk of cancer was significantly lower than that of the DPP‐4i cohort for leukaemia, oesophageal, colorectal, liver, pancreatic, lung, skin and bladder cancer.ConclusionsSGLT‐2i use was associated with a significantly lower risk of cancer than DPP‐4i use.

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Section: Discussionmentioning

confidence: 96%

Comparison between sodium‐glucose cotransporter 2 inhibitors and dipeptidyl peptidase 4 inhibitors on the risk of incident cancer in patients with diabetes mellitus: A real‐world evidence study

Sung,

Hung,

Tung

et al. 2024

Diabetes Metabolism Res

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show abstract

“…DM is also associated with cancer development through a complex mechanism. Treatment with SGLT-2 inhibitors can diminish the risk of cancer incidence in DM patients [138] because gliflozins have anticancer activity through various mechanisms, as previously shown [139][140][141][142][143][144][145]. Moreover, SGLT-2 inhibitors can protect DM patients against the cardiotoxic action of anticancer drugs [31].…”

Section: Sglt-2 Inhibitors In the Therapy Of Dm Complications And Com...mentioning

confidence: 95%

Risks and Benefits of SGLT-2 Inhibitors for Type 1 Diabetes Patients Using Automated Insulin Delivery Systems—A Literature Review

Elian,

Popovici,

Karampelas

et al. 2024

IJMS

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The primary treatment for autoimmune Diabetes Mellitus (Type 1 Diabetes Mellitus-T1DM) is insulin therapy. Unfortunately, a multitude of clinical cases has demonstrated that the use of insulin as a sole therapeutic intervention fails to address all issues comprehensively. Therefore, non-insulin adjunct treatment has been investigated and shown successful results in clinical trials. Various hypoglycemia-inducing drugs such as Metformin, glucagon-like peptide 1 (GLP-1) receptor agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, amylin analogs, and Sodium-Glucose Cotransporters 2 (SGLT-2) inhibitors, developed good outcomes in patients with T1DM. Currently, SGLT-2 inhibitors have remarkably improved the treatment of patients with diabetes by preventing cardiovascular events, heart failure hospitalization, and progression of renal disease. However, their pharmacological potential has not been explored enough. Thus, the substantial interest in SGLT-2 inhibitors (SGLT-2is) underlines the present review. It begins with an overview of carrier-mediated cellular glucose uptake, evidencing the insulin-independent transport system contribution to glucose homeostasis and the essential roles of Sodium-Glucose Cotransporters 1 and 2. Then, the pharmacological properties of SGLT-2is are detailed, leading to potential applications in treating T1DM patients with automated insulin delivery (AID) systems. Results from several studies demonstrated improvements in glycemic control, an increase in Time in Range (TIR), a decrease in glycemic variability, reduced daily insulin requirements without increasing hyperglycemic events, and benefits in weight management. However, these advantages are counterbalanced by increased risks, particularly concerning Diabetic Ketoacidosis (DKA). Several clinical trials reported a higher incidence of DKA when patients with T1DM received SGLT-2 inhibitors such as Sotagliflozin and Empagliflozin. On the other hand, patients with T1DM and a body mass index (BMI) of ≥27 kg/m2 treated with Dapagliflozin showed similar reduction in hyperglycemia and body weight and insignificantly increased DKA incidence compared to the overall trial population. Additional multicenter and randomized studies are required to establish safer and more effective long-term strategies based on patient selection, education, and continuous ketone body monitoring for optimal integration of SGLT-2 inhibitors into T1DM therapeutic protocol.

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Beneficial effect of sodium-glucose cotransporter-2 inhibitors on mortality among patients with cancer and diabetes mellitus

Hu,

Lin

2024

Naunyn-Schmiedeberg's Arch Pharmacol

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Patients with diabetes with and without sodium-glucose cotransporter-2 inhibitors use with incident cancer risk

Cited by 6 publications

References 11 publications

Comparison between sodium‐glucose cotransporter 2 inhibitors and dipeptidyl peptidase 4 inhibitors on the risk of incident cancer in patients with diabetes mellitus: A real‐world evidence study

Comparison between sodium‐glucose cotransporter 2 inhibitors and dipeptidyl peptidase 4 inhibitors on the risk of incident cancer in patients with diabetes mellitus: A real‐world evidence study

Risks and Benefits of SGLT-2 Inhibitors for Type 1 Diabetes Patients Using Automated Insulin Delivery Systems—A Literature Review

Beneficial effect of sodium-glucose cotransporter-2 inhibitors on mortality among patients with cancer and diabetes mellitus

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