PMID- 24931333
OWN - NLM
STAT- MEDLINE
DCOM- 20150416
LR  - 20220318
IS  - 1365-2362 (Electronic)
IS  - 0014-2972 (Linking)
VI  - 44
IP  - 8
DP  - 2014 Aug
TI  - Treatment with human insulin does not increase thyroid cancer risk in patients 
      with type 2 diabetes.
PG  - 736-42
LID - 10.1111/eci.12290 [doi]
AB  - BACKGROUND: Whether human insulin therapy may increase thyroid cancer risk in 
      patients with type 2 diabetes mellitus (T2DM) has not been investigated. 
      MATERIALS AND METHODS: The reimbursement databases of all Taiwanese diabetic 
      patients from 1996 to 2009 were retrieved from the Bureau of National Health 
      Insurance. The entry date was set at 1 January 2004, and 968,384 patients with 
      T2DM were followed up for thyroid cancer incidence until the end of 2009. 
      Ever-users, never-users and subgroups of human insulin exposure (using tertile 
      cut-offs of time since starting insulin, duration of therapy and cumulative dose) 
      at entry date were calculated for thyroid cancer incidence. Insulin glargine was 
      not marketed until after the entry date. Therefore, to exclude the potential 
      contamination of insulin glargine, patients who happened to use insulin glargine 
      were censored at the time of its initiation when calculating the period of 
      follow-up. Hazard ratios were estimated by Cox regression. RESULTS: There were 
      111,121 ever-users and 857,263 never-users of human insulin, with respective 
      numbers of incident thyroid cancer of 118 (0.11%) and 1047 (0.12%), and 
      respective incidences of 23.9 and 23.8 per 100,000 person-years. The overall 
      hazard ratios (95% confidence intervals) did not show a significant association 
      with human insulin in either the age-sex-adjusted or the fully adjusted model: 
      0.942 (0.778-1.141) and 1.096 (0.888-1.353), respectively. When categorized into 
      tertiles of the dose-response parameters, none of the hazard ratios was 
      significant. CONCLUSIONS: This study does not support the role of human insulin 
      therapy in increasing the risk of thyroid cancer in patients with T2DM.
CI  - (c) 2014 Stichting European Society for Clinical Investigation Journal Foundation.
FAU - Tseng, Chin-Hsiao
AU  - Tseng CH
AD  - Department of Internal Medicine, National Taiwan University College of Medicine, 
      Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Internal 
      Medicine, National Taiwan University Hospital, Taipei, Taiwan; Division of 
      Environmental Health and Occupational Medicine, National Health Research 
      Institutes, Taipei, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Clin Invest
JT  - European journal of clinical investigation
JID - 0245331
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin, Regular, Human)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/*adverse effects
MH  - Insulin, Regular, Human/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Thyroid Neoplasms/*chemically induced
OTO - NOTNLM
OT  - Diabetes
OT  - Taiwan
OT  - epidemiology
OT  - insulin
OT  - thyroid cancer
EDAT- 2014/06/17 06:00
MHDA- 2015/04/17 06:00
CRDT- 2014/06/17 06:00
PHST- 2013/12/15 00:00 [received]
PHST- 2014/06/11 00:00 [accepted]
PHST- 2014/06/17 06:00 [entrez]
PHST- 2014/06/17 06:00 [pubmed]
PHST- 2015/04/17 06:00 [medline]
AID - 10.1111/eci.12290 [doi]
PST - ppublish
SO  - Eur J Clin Invest. 2014 Aug;44(8):736-42. doi: 10.1111/eci.12290.