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Exp Clin Endocrinol Diabetes 2008; 116(3): 184-189
DOI: 10.1055/s-2007-992157
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Treatment with Insulin Secretagogues and Cancer-Related Mortality in Type 2 Diabetic Patients A Retrospective Cohort Study

M. Monami 1 , C. Lamanna 1 , L. Pala 2 , G. Bardini 2 , B. Cresci 2 , P. Francesconi 3 , D. Balzi 4 , N. Marchionni 1 , C. M. Rotella 2 , E. Mannucci 1
  • 1Department of Critical Care Medicine and Surgery, Unit of Geriatrics, University of Florence and AOU Careggi, Florence, Italy
  • 2Section of Endocrinology, Department of Clinical Pathophysiology, University of Florence and AOU Careggi, Florence, Italy
  • 3ARSA (Agenzia Regionale Sanità), Unit of Epidemiology, Florence, Italy
  • 4Epidemiology Unit, Local Health Unit 10, Florence, Italy
Further Information

Publication History

received 14.09.2007 first decision 09.10.2007

accepted 09.10.2007

Publication Date:
14 February 2008 (online)

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Abstract

Background: Recent evidence suggests that some hypoglycemic treatments could affect the incidence of malignancies. This study was aimed at the assessment of cancer-related mortality in type 2 diabetic patients treated with different hypoglycemic drugs.

Methods: A retrospective observational cohort study was performed on a consecutive series of 3002 type 2 diabetic outpatients. Cancer-related death was identified through the City Registry Office. For patients visited for the first time after January 1st, 2000, information on incidence of cancer was also available.

Results: During a mean follow-up of 4.3±2.5 years, 87 cases of cancer-related death were recorded, with a yearly incidence rate of 0.70%. Patients receiving secretagogues showed a significantly higher mortality than the rest of the sample (unadjusted OR [95%CI] 1.76 [1.15-2.69], p=0.009), which was maintained after adjustment for confounders (HR 2.29 [1.21-4.02], p=0.003). Conversely, no significant association of cancer-related mortality was observed with insulin sensitizers or exogenous insulin. In comparison with patients receiving no hypoglycemic treatment, those on secretagogue or insulin monotherapy showed a higher cancer-related mortality (HR 2.25 [1.10-4.78], p=0.034 and HR 2.11 [1.01-4.50], p=0.048, respectively). The effect of treatments on incidence of malignancies was similar to that observed on cancer-related death.

Conclusions Insulin secretagogues and, to a lesser extent, exogenous insulin, appear to be associated with increased mortality for cancer, even after adjustment for multiple confounders. This issue deserves further investigation through epidemiological studies on larger samples of patients.

Key words

diabetes mellitus - hypoglycemic drugs - cancer - glibenclamide

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Correspondence

E. MannucciMD 

Department of Critical Care Medicine and Surgery

Unit of Geriatrics

University of Florence and Azienda Ospedaliero-Universitaria Careggi

Via delle Oblate 4:

50134 Florence

Italy

Phone: +39/055/794 94 30

Fax: +39/055/794 96 60

Email: edoardo.mannucci@fastwebnet.it

Email: mmonami@libero.it

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