Metformin May Lower Risk of Cancer Death
What is the problem and what is known about it so far?
Many people with diabetes became worried recently when reports were published suggesting that there might be a link between the widely used insulin glargine and a higher risk of cancer. Later reports cast doubts on the link and recommended no changes in prescribing for glargine. The news and continuing debate about glargine overshadowed more positive news suggesting that the diabetes drug metformin—the preferred first medicine for people with type 2 diabetes—may reduce the risk of cancer and help people who already have certain types of cancer. A study that looked at the risk of death from cancer found that people taking diabetes drugs from the sulfonylurea class or insulin were more likely to die from cancer than those taking metformin. However, this study had some design problems that may have affected its results.
Why did the researchers do this particular study?
The researchers wanted to design a better study to look at how taking metformin affects the risk of dying from cancer for people with type 2 diabetes.
Who was studied?
The study included 1,353 patients with type 2 diabetes who were enrolled in a larger study of medical care in the Netherlands in 1998 and 1999.
How was the study done?
The participants were reviewed in 2009 to see which had died from cancer. Researchers looked at the link between dying from cancer and taking metformin while taking many other factors into account.
What did the researchers find?
After about 10 years, participants who were taking metformin at the start of the initial study were less likely to have died from cancer than those who were not. Those taking higher doses of metformin had greater protection from cancer death than those taking lower doses.
What were the limitations of the study?
A person's chance of dying from cancer is related to the type of cancer he or she has and how aggressively it is treated. The researchers could not collect information about participants who had cancer but did not die or about whether their diabetes affected the types of cancer treatment they received. Also, researchers did not have enough information to take into account whether some participants had had cancer previously. The study did not include enough deaths from cancer for researchers to find out whether metformin affects specific types of cancer in different ways. Also, metformin was not used as wisely when the initial study started in 1998. Therefore patients who were taking metformin in 1998 may have differed from other patients in ways that could have affected the results of this study.
What are the implications of the study
People with type 2 diabetes who take metformin are less likely to die from cancer than those who do not, although more research is needed to find out why this is so. This may add another reason why metformin should be the first medicine used for most people with type 2 diabetes.
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