Dr. Yuanjie Mao has led a study published within the Journal of the American Medical Association (JAMA) Oncology taking a look at the correlation between every day insulin dose and cancer incidence (the number of latest cases) amongst patients with type 1 diabetes, finding that higher insulin dose is positively related to cancer incidence and that the association is stronger amongst those with insulin resistance.

In patients with type 1 diabetes, our results show that traditional metabolic aspects equivalent to obesity (represented by body mass index), sugar control (represented by Hemoglobin A1c), and blood pressure control don’t associate with cancer incidence. Nonetheless, cancer incidence was higher for individuals who took larger dose of insulin. Our results implied that clinicians might have to balance the potential cancer risk when treating patients with type 1 diabetes on a high every day insulin dose or that improving insulin sensitivity could also be preferred than simply increasing the insulin dose.”

Dr. Yuanjie Mao

To conduct the study, Mao collaborated with Wenjun Zhong, Ph.D., an epidemiologist of Merck Research Labs in West Point, Pa. to research the associations of greater than 50 common risk aspects equivalent to smoking, alcohol use, exercise, metabolic risk aspects, medication use and family history with cancer incidence in 1,303 patients with type 1 diabetes whose data were collected over 28 years. They acquired data from The Diabetes Control and Complications Trial (DCCT) and its follow up, the Epidemiology of Diabetes Interventions and Complications (EDIC) study, from the National Institute of Diabetes and Digestive and Kidney Diseases Central Repository and performed statistical evaluation on them. DCCT was a controlled clinical trial originating with 1,441 patients with type 1 diabetes who were randomized into conventional diabetes therapy or intensive therapy to evaluate whether reducing hyperglycemia would decrease the chance of complications of type 1 diabetes.

Mao also found that age and sex are related to cancer incidence when evaluated individually and that a every day insulin dose posed the next risk of cancer than age, especially the next insulin dose.

In accordance with the paper, when the every day insulin dose is assessed into three groups, low: lower than 0.5; medium: greater than or equal to 0.5 or lower than 0.8; and high: greater than or equal to 0.8 units/kg per day, the hazard ratios were significantly higher within the high dose versus the low dose group. Cancer incidence was 2.11, 2.87, and a pair of.91 per 1,000 individuals within the low, medium, and high insulin dose groups, respectively.

He went on to clarify that specifically, women carry the next risk than men; nevertheless, it was unclear what risk aspects may contribute to the upper cancer incidence in type 1 diabetes.

“We all know that individuals with type 1 diabetes have the next incidence of cancer in comparison with people without diabetes,” Liz Beverly, Ph.D. co-director of the diabetes institute and professor within the Heritage College, said. “Dr. Mao’s research identifies a possible mechanism to clarify this association. His findings will result in continued research on this area and potential policy changes in cancer screening and insulin dosing recommendations.”

Although previous studies have concluded that patients with diabetes have the next risk of cancer basically, that is the primary study to explore the associated cancer incidence aspects in type 1 diabetes.

“Type 1 diabetes accounts for an estimated five to 10 percent of all diabetes cases, and up to date studies in type 1 diabetes also found the next incidence of certain cancers equivalent to stomach, liver, pancreas, endometrium and kidney cancers within the population compared with the final population,” Mao explained. “Whereas, in type 2 diabetes, increased risk is attributed to metabolic aspects equivalent to obesity, chronic inflammation status, and insulin resistance.”

Although the outcomes of the study suggest that the upper the dose of insulin, the upper the cancer incidence, Mao says further investigation remains to be mandatory.

Mao graduated from Peking University with an M.D. and Ph.D. and had residency training in internal medicine on the Cleveland Clinic Akron General and fellow training in Endocrinology, Diabetes, and Metabolism on the University of Arkansas. Since then, he has been working at Ohio University as an assistant clinical professor within the Department of Specialty Medicine and the Diabetes Institute. He can also be working with OhioHealth as an endocrinologist within the Castrop Center and at O’Bleness Hospital. His specialization is in diabetes, thyroid diseases, osteoporosis, and other endocrine disorders. Along with the present study, he can also be working on several other clinical trials on obesity, type 1 diabetes, and kind 2 diabetes.

Source:

Journal reference:

Zhong, W & Mao,Y., (2022) Each day Insulin Dose and Cancer Risk Amongst Patients With Type 1 Diabetes. JAMA. doi.org/10.1001/jamaoncol.2022.2960.