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. 2023 Feb 8;15(4):1094.
doi: 10.3390/cancers15041094.

Analysis of the Incidence of Type 2 Diabetes, Requirement of Insulin Treatment, and Diabetes-Related Complications among Patients with Cancer

Su Jung Lee  1 , Chulho Kim  2   3 , Hyunjae Yu  3 , Dong-Kyu Kim  3   4
Affiliations

Analysis of the Incidence of Type 2 Diabetes, Requirement of Insulin Treatment, and Diabetes-Related Complications among Patients with Cancer

Su Jung Lee et al. Cancers (Basel). .

Abstract

This retrospective nationwide population-based cohort study used a dataset collected from the Korean National Health Insurance Service. We evaluated incident type 2 diabetes, insulin requirements, and diabetes-associated complications during a 10-year follow-up period using the log-rank test and Cox proportional hazards regression models. In total, 8114 and 16,228 individuals with and without cancer, respectively, were enrolled. We found a higher incidence rate and an increased adjusted hazard ratio (HR) for new cases of type 2 diabetes in patients with cancer, compared with those without cancer. Additionally, patients with cancer had a higher risk of insulin requirement than patients without cancer (adjusted HR 1.43, 95% confidence interval [CI], 1.14-1.78). Although there was no significant association between diabetes-associated complications and overall cancer diagnosis, specific cancer types (pancreas, bladder, and prostate) showed an increased risk of subsequent diabetic nephropathy. Therefore, clinicians should closely monitor patients with cancer for the early detection of type 2 diabetes and related morbidities.

Keywords: cohort studies; diabetes mellitus; early detection of cancer; insulin; neoplasms; type 2.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Schematic description of the study design; (B) flow of enrollment of study participants.
Figure 2
Figure 2
Incidence rate and hazard ratio of type 2 diabetes by cancer type. * p < 0.05, ** p < 0.010, and *** p < 0.001.
Figure 3
Figure 3
Incidence rate and adjusted hazard ratio for cases requiring insulin treatment in patients with type 2 diabetes by cancer type. * p < 0.05, ** p < 0.010, and *** p < 0.001.
Figure 4
Figure 4
Risk of requiring insulin treatment in patients with liver, gallbladder, pancreas, lung, and hematologic malignancy by time.
Figure 5
Figure 5
Incidence rate and adjusted hazard ratio for cases of diabetes-associated complications in patients with type 2 diabetes by cancer type. * p < 0.05, ** p < 0.010, and *** p < 0.001.
Figure 6
Figure 6
Risk of diabetes-associated complications in patients with pancreas, breast, bladder, and prostate malignancy by time.
Figure 7
Figure 7
Subgroup analysis for incidence and risk of specific diabetes-associated complications in patients with specific cancer (pancreas, bladder, and prostate). *** p < 0.001.
See this image and copyright information in PMC

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