Vnitr Lek 2011, 57(9):760-763

Is there any relation between diabetes tharapy and cancer risk?

Š. Svačina
III. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA

Type 2 diabetes is associated with increased risk of cancer. This risk is related to HbA1c increase and this influence is present also in prediabetes and in nondiabetics with HbA1c in upper normal range. In last 2 years, it was concluded that that the specific antidiabetic therapy could influence the cancer risk. In this review we show that reduction of HbA1c does not change cancer risk. Most important is the risk reduction of cancer risk by metformin. Insulin therapy and the use of sulphonylurea related drugs, increases the risk of cancer. This risk can be eliminated in the combination with metformin. Other published results including the suspected effect related to the use of glargine, pioglitazone, sitagliptine and exenatide are inconsistent and analysis of long term effects of these drugs is necessary. The large discussion in many publications shows the important role of FDA and EMA. This agencies do not suspend drugs without consistent evaluation of results.

Keywords: glycemic control; cancer risk; prediabetes; metformin; derivates of sulphonylurea; insulin therapy; glargine; detemir; pioglitazone; sitagliptine

Received: July 17, 2011; Published: September 1, 2011  Show citation

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Svačina Š. Is there any relation between diabetes tharapy and cancer risk? Vnitr Lek. 2011;57(9):760-763.
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References

  1. Masur K, Thévenod F, Zanker KS (eds). Diabetes and cancer. Frontiers in diabetes. Vol. 19. Basel: Karger 2008. Go to original source...
  2. Wilson EB, Maher HC. Cancer and tuberculosis with some comments on cancer and other diseases. Am J Cancer 1932; 16: 227-250.
  3. Svačina Š. Nádory ledvin, močového měchýře a prostaty u obezity a diabetu. Vnitř Lék 2008; 54: 464-467. Go to PubMed...
  4. Svačina Š, Matoulek M, Svobodová Š et al. Nádory trávicího traktu a diabetes. Vnitř Lék 2004; 50: 386-391. Go to PubMed...
  5. Friberg E, Orsini N, Mantzoros CS et al. Diabetes mellitus and risk of endometrial cancer: a meta-analysis. Diabetologia 2007; 50: 1365-1374. Go to original source... Go to PubMed...
  6. Mitri J, Castillo J, Pittas AG. Diabetes and risk of Non-Hodgkin's lymphoma: a meta-analysis of observational studies. Diabetes Care 2008; 31: 2391-2397. Go to original source... Go to PubMed...
  7. Velicer CM, Dublin S, White E. Diabetes and the risk of prostate cancer: the role of diabetes treatment and complications. Prostate Cancer Prostatic Dis 2007; 10: 46-51. Go to original source... Go to PubMed...
  8. Giovannucci E, Harlan DM, Archer MC et al. Diabetes and cancer: a consensus report. Diabetes Care 2010; 33: 1674-1685. Go to original source... Go to PubMed...
  9. Renehan A, Smith U, Kirkman MS. Linking diabetes and cancer: a consensus on complexity. Lancet 2010; 375: 2201-2202. Go to original source... Go to PubMed...
  10. Smith U, Gale EA. Cancer and diabetes: Are we ready for prime time? Diabetologia 2010; 53: 1541-1544. Go to original source... Go to PubMed...
  11. Zhou XH, Qiao Q, Zethelius B et al. DECODE Study Group. Diabetes, prediabetes and cancer mortality. Diabetologia 2010; 53: 1867-1876. Go to original source... Go to PubMed...
  12. Nathan DM, Davidson MB, DeFronzo RA et al. American Diabetes Association. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care 2007; 30: 753-759. Go to original source... Go to PubMed...
  13. Pfister R, Sharp SJ, Luben R et al. No evidence of an increased mortality risk associated with low levels of glycated haemoglobin in a non-diabetic UK population. Diabetologia 2011; 54: 2025-2032. Go to original source... Go to PubMed...
  14. Johnson JA, Bowker SL. Intensive glycaemic control and cancer risk in type 2 diabetes: a meta-analysis of major trials. Diabetologia 2011; 54: 25-31. Go to original source... Go to PubMed...
  15. Stefansdottir G, Zoungas S, Chalmers J et al. Intensive glucose control and risk of cancer in patients with type 2 diabetes. Diabetologia 2011; 54: 1608-1614. Go to original source... Go to PubMed...
  16. Johnson JA, Bowker SL, Richardson K et al. Time-varying incidence of cancer after the onset of type 2 diabetes: evidence of potential detection bias. Diabetologia 2011; Jul 12. [Epub]. Go to original source... Go to PubMed...
  17. Sjöström L, Gummesson A, Sjöström CD et al. Swedish Obese Subjects Study. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol 2009; 10: 653-662. Go to original source... Go to PubMed...
  18. Currie CJ, Poole CD, Gale EA. The influence of glucose-lowering therapies on cancer risk in type 2 diabetes. Diabetologia 2009; 52: 1766-1777. Go to original source... Go to PubMed...
  19. Landman GW, Kleefstra N, van Hateren KJ et al. Metformin associated with lower cancer mortality in type 2 diabetes: ZODIAC-16. Diabetes Care 2010; 33: 322-326. Go to original source... Go to PubMed...
  20. Libby G, Donnelly LA, Donnan PT et al. New users of metformin are at low risk of incident cancer: a cohort study among people with type 2 diabetes. Diabetes Care 2009; 32: 1620-1625. Go to original source... Go to PubMed...
  21. Bodmer M, Meier C, Krähenbühl S et al. Long-term metformin use is associated with decreased risk of breast cancer. Diabetes Care 2010; 33: 1304-1308. Go to original source... Go to PubMed...
  22. Brown KA, Hunger NI, Docanto M et al. Metformin inhibits aromatase expression in human breast adipose stromal cells via stimulation of AMP-activated protein kinase. Breast Cancer Res Treat 2010; 123: 591-596. Go to original source... Go to PubMed...
  23. Wright JL, Stanford JL. Metformin use and prostate cancer in Caucasian men: results from a population-based case-control study. Cancer Causes Control 2009; 20: 1617-1622. Go to original source... Go to PubMed...
  24. Ben Sahra I, Le Marchand-Brustel Y, Tanti JF et al. Metformin in cancer therapy: a new perspective for an old antidiabetic drug? Mol Cancer Ther 2010; 9: 1092-1099. Go to original source... Go to PubMed...
  25. Kalender A, Selvaraj A, Kim SY et al. Metformin, independent of AMPK, inhibits mTORC1 in a rag GTPase-dependent manner. Cell Metab 2010; 11: 390-401. Go to original source... Go to PubMed...
  26. Svačina Š. Význam struktury inzulinových přípravků pro klinickou praxi. Vnitř Lék 2009; 55: 409-411. Go to PubMed...
  27. Ciaraldi TP, Sasaoka T. Review on the in vitro interaction of insulin glargine with the insulin/insulin-like growth factor system: potential implications for metabolic and mitogenic activities. Horm Metab Res 2011; 43: 1-10. Go to original source... Go to PubMed...
  28. Mayer D, Chantelau E. Treatment with insulin glargine (Lantus) increases the proliferative potency of the serum of patients with type-1 diabetes: a pilot study on MCF-7 breast cancer cells. Arch Physiol Biochem 2010; 16: 173-178. Go to original source... Go to PubMed...
  29. Pocock SJ, Smeeth L. Insulin glargine and malignancy: an unwarranted alarm. Lancet 2009; 374: 511-513. Go to original source... Go to PubMed...
  30. Edwards KL, Riche DM, Stroup JS et al. Insulin glargine and cancer risk: an opinion statement of the Endocrine and Metabolism Practice and Research Network of the American College of Clinical Pharmacy. Pharmacotherapy 2010; 30: 955-965. Go to original source... Go to PubMed...
  31. Rosenstock J, Fonseca V, McGill JB et al. Similar risk of malignancy with insulin glargine and neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes: findings from a 5 year randomised, open-label study. Diabetologia 2009; 52: 1971-1973. Go to original source... Go to PubMed...
  32. Dejgaard A, Lynggaard H, Råstam J et al. No evidence of increased risk of malignancies in patients with diabetes treated with insulin detemir: a meta-analysis. Diabetologia 2009; 52: 2507-2512. Go to original source... Go to PubMed...
  33. Suissa S, Azoulay L, Dell'aniello S et al. Long-term effects of insulin glargine on the risk of breast cancer. Diabetologia 2011 [Epub ahead of print]. Go to original source... Go to PubMed...
  34. Lewis JD, Ferrara A, Peng T et al. Risk of bladder cancer among diabetic patients treated with pioglitazone: interim report of a longitudinal cohort study. Diabetes Care 2011; 34: 916-922. Go to original source... Go to PubMed...
  35. Ferrara A, Lewis JD, Quesenberry CP Jr et al. Cohort study of pioglitazone and cancer incidence in patients with diabetes. Diabetes Care 2011; 34: 923-929. Go to original source... Go to PubMed...
  36. Elashoff M, Matveyenko AV, Gier B et al. Pancreatitis, pancreatic, and thyroid cancer with glucagon-like Peptide-1-based therapies. Gastroenterology 2011; 141: 150-156. Go to original source... Go to PubMed...
  37. Abstract book 71th Scientific Sessions ADA. Diabetes 2011; 60: Suppl 1. Go to PubMed...




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