Type 2 diabetes mellitus, glycemic control, and cancer risk

Onitilo, Adedayo A., Stankowski, Rachel V., Berg, Richard L., Engel, Jessica M., Glurich, Ingrid, Williams, Gail M. and Doi, Suhail A. (2014) Type 2 diabetes mellitus, glycemic control, and cancer risk. European Journal of Cancer Prevention, 23 2: 134-140. doi:10.1097/CEJ.0b013e3283656394


Author Onitilo, Adedayo A.
Stankowski, Rachel V.
Berg, Richard L.
Engel, Jessica M.
Glurich, Ingrid
Williams, Gail M.
Doi, Suhail A.
Title Type 2 diabetes mellitus, glycemic control, and cancer risk
Journal name European Journal of Cancer Prevention   Check publisher's open access policy
ISSN 0959-8278
1473-5709
Publication date 2014-01-01
Year available 2014
Sub-type Article (original research)
DOI 10.1097/CEJ.0b013e3283656394
Open Access Status Not Open Access
Volume 23
Issue 2
Start page 134
End page 140
Total pages 7
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams and Wilkins
Language eng
Subject 1306 Cancer Research
2730 Oncology
2713 Epidemiology
2739 Public Health, Environmental and Occupational Health
Abstract Type 2 diabetes mellitus is characterized by prolonged hyperinsulinemia, insulin resistance, and progressive hyperglycemia. Disease management relies on glycemic control through diet, exercise, and pharmacological intervention. The goal of the present study was to examine the effects of glycemic control and the use of glucose-lowering medication on the risk of breast, prostate, and colon cancer. Patients diagnosed with type 2 diabetes mellitus (N=9486) between 1 January 1995 and 31 December 2009 were identified and data on glycemic control (hemoglobin A1c, glucose), glucose-lowering medication use (insulin, metformin, sulfonylurea), age, BMI, date of diabetes diagnosis, insurance status, comorbidities, smoking history, location of residence, and cancer diagnoses were electronically abstracted. Cox proportional hazards regression modeling was used to examine the relationship between glycemic control, including medication use, and cancer risk. The results varied by cancer type and medication exposure. There was no association between glycemic control and breast or colon cancer; however, prostate cancer risk was significantly higher with better glycemic control (hemoglobin A1c≤7.0%). Insulin use was associated with increased colon cancer incidence in women, but not with colon cancer in men or breast or prostate cancer risk. Metformin exposure was associated with reduced breast and prostate cancer incidence, but had no association with colon cancer risk. Sulfonylurea exposure was not associated with risk of any type of cancer. The data reported here support hyperinsulinemia, rather than hyperglycemia, as a major diabetes-related factor associated with increased risk of breast and colon cancer. In contrast, hyperglycemia appears to be protective in the case of prostate cancer.
Keyword Cancer
Diabetes mellitus
Glycemic Control
Incidence
Risk
Type 2 diabetes mellitus
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: School of Public Health Publications
Official 2015 Collection
 
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