Objective. To investigate the association between type 2 diabetes, glucose-lowering therapies (monotherapy with either metformin,\r\nsulphonylurea or insulin) and cancer risk in Taiwan. Methods. Using Taiwanââ?¬â?¢s National Health Research Institutes database of\r\n1,000,000 random subjects from 2000ââ?¬â??2008, we found 61777 patients with type 2 diabetes (age =20 years) and 677378 enrollees\r\nwith no record of diabetes. Results. After adjusting for age and sex, we found patients with diabetes to have significantly higher risk\r\nof all cancers (OR: 1.176; 95% CI: 1.149ââ?¬â??1.204,P < 0.001). Diabetic patients treated with insulin or sulfonylureas had significantly\r\nhigher risk of all cancers, compared to those treated with metformin (OR: 1.583; 95% CI: 1.389ââ?¬â??1.805, P < 0.001 and OR: 1.784;\r\n95% CI: 1.406ââ?¬â??2.262, P < 0.001). Metformin treatment was associated with a decreased risk of colon and liver cancer compared\r\nto sulphonylureas or insulin treatment. Sulfonylureas treatment was associated with an increased risk of breast and lung cancer\r\ncompared to metformin therapy. Conclusions. Taiwanese with type 2 diabetes are at a high risk of breast, prostate, colon, lung, liver\r\nand pancreatic cancer. Those treated with insulin or sulfonylureas monotherapy are more likely to develop colon and liver cancer\r\nthan those treated with metformin.
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