Cancer Risk Associated with Insulin Glargine among Adult Type 2 Diabetes Patients – A Nationwide Cohort Study
2011

Cancer Risk Associated with Insulin Glargine among Adult Type 2 Diabetes Patients

Sample size: 59243 publication 10 minutes Evidence: moderate

Author Information

Author(s): Chang Chia-Hsu, Toh Sengwee, Lin Jou-Wei, Chen Shu-Ting, Kuo Chuei-Wen, Chuang Lee-Ming, Lai Mei-Shu

Primary Institution: Institute of Preventive Medicine, College of Public Health, National Taiwan University

Hypothesis

Does the use of insulin glargine increase cancer incidence compared to intermediate/long-acting human insulin?

Conclusion

Insulin glargine use did not increase the risk of overall cancer incidence compared to human insulin, but there were positive associations with pancreatic and prostate cancer that require further evaluation.

Supporting Evidence

  • The incidence rate of all cancer per 1,000 person-years was 13.8 for insulin glargine initiators and 16.0 for HI initiators.
  • No significant difference in overall cancer risk was found between insulin glargine and HI initiators.
  • Adjusted hazard ratios indicated increased risk for pancreatic and prostate cancer in men using insulin glargine.

Takeaway

This study looked at whether a diabetes medicine called insulin glargine causes cancer. It found that it doesn't seem to cause more cancer overall, but it might be linked to some specific types of cancer in men.

Methodology

A retrospective cohort study using the Taiwan National Health Insurance claims database was conducted to identify adult patients with type 2 diabetes who initiated insulin glargine or intermediate/long-acting human insulin.

Potential Biases

Potential biases include reverse causation and detection bias due to more frequent clinical visits among insulin glargine users.

Limitations

The study could not examine long-term effects of insulin glargine on cancer and may have residual confounding by diabetes severity and other risk factors.

Participant Demographics

The study included 10,190 insulin glargine initiators and 49,253 intermediate/long-acting HI initiators, with a mean age of approximately 60 years.

Statistical Information

P-Value

0.86

Confidence Interval

95% CI 1.01–4.59 for pancreatic cancer; 95% CI 1.50–8.40 for prostate cancer.

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0021368

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