Journal of Cancer Research and Clinical Oncology, 2000, Vol.126(7), pp.412-417
In patients with diabetes mellitus, contradictory results have been reported indicating both increased and reduced risks of malignancies. In the present trial all insulin-treated diabetic patients ( n = 2720) attending our centre since 1995 were studied. Of these patients, 28 (type 1/type 2: n = 1/27, 23 women) developed malignancies during insulin therapy: 11 patients developed cancer of the breast, 4 patients cancer of the pancreas, 3 patients cancer of the kidneys and 10 patients developed other malignancies. The characteristics of these patients [mean ± SD (range)] were as follows: age 68.8 ± 8.6 (52.0–87.0) years, diabetes duration 13.1 ± 8.1 (0.5–29.0) years, duration of insulin therapy at the time of the diagnosis of malignancy 4.3 ± 5.7 (0.5–24.0) years, insulin dosage 0.67 ± 0.43 (0.11–1.72) IU/kg body weight, mean HbA1c 9.6 ± 1.9 (6.8–14.9)% (HPLC, Diamat, normal range 4.4%–5.9%). The prevalences of nephropathy, retinopathy (non-proliferative: n = 7) and peripheral neuropathy were 35.7%, 25.0% and 46.4% respectively. When the features of the 27 patients with type 2 diabetes were compared with the characteristics of the type 2 diabetic patients ( n = 117, 63 women) studied in a population-based survey of insulin-treated diabetic patients, also performed in the area of Jena [JEVIN; Schiel R et al. (1997a)] there were no significant differences in the duration of insulin therapy (JEVIN: 4.7 ± 4.3 years, P = 0.64), insulin dosage (JEVIN: 0.55 ± 0.27 IU/kg body weight, P = 0.08), mean HbA1c (JEVIN: 9.0 ± 2.1%, P = 0.16) and the prevalences of long-term complications of diabetes. The quality of diabetes control in insulin-treated patients suffering from malignancies is comparable to that of a selection-free population of diabetic patients. Furthermore, in comparison to non-diabetic subjects our diabetic patients showed no altered risk for malignancies as a function of insulin dosage, the duration of diabetes or insulin therapy, the quality of diabetes control or the prevalence of long-term complications of the disease.
Key words Type 1 diabetes mellitus ; Type 2 diabetes mellitus ; Cancer ; Neoplasia ; HbA1c ; Nephropathy ; Retinopathy ; Peripheral neuropathy
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