Insulin glargine vs. NPH did not increase risk for cancer
Despite recent studies investigating possible associations between insulin glargine and cancer, the risk is no higher with glargine vs. human neutral protamine Hagedorn insulin, according to researchers.
“In our large, new user, active comparator cohort study, we found no evidence that initiating patients with diabetes with insulin glargine leads to a higher risk of cancer compared with initiating similar patients on human insulin (NPH),” Til Stürmer, MD, PhD, of the department of epidemiology at the University of North Carolina at Chapel Hill, and colleagues wrote. “This result was consistent for overall and specific cancers (breast, prostate, colon) and a variety of sensitivity analyses addressing the relation of timing of insulin initiation with the risk for cancer (time after initiation, induction periods, lag times), subgroups, and the potential for unmeasured confounding by BMI and severity of diabetes.”
The researchers collected data from registries to identify patients who were initially prescribed insulin glargine or NPH. According to data, more patients initiated glargine (n=43,306) compared with NPH (n=9,147). Of those patients who started on glargine, with a mean follow-up of 1.2 years (50,548 person-years), 993 developed cancer (HR=1.12; 95% CI, 0.95-1.32).
“Based on previous studies and the substantial contribution of our study, we conclude that there does not seem to be an increased risk for cancer, including breast cancer, after initiation of glargine compared with NPH in patients with mostly type 2 diabetes,” the researchers wrote.
Disclosure: Stürmer reports research funding as principal investigator of the UNC DEcIDE center from the Agency for Healthcare Research and Quality and from the Patient Centered Outcomes Research Institute. He receives salary support from the Center for Pharmacoepidemiology, funded by GlaxoSmithKline; unrestricted research grants from Merck and Sanofi to the University of North Carolina. See the full study for other researchers’ relevant financial disclosures.