Featured Research

from universities, journals, and other organizations

Insulin Analogue Glargine Possibly Increases Cancer Risk

Date:
June 29, 2009
Source:
Institute for Quality and Efficiency in Health Care
Summary:
The risk of cancer possibly increases if patients with diabetes use the long-acting insulin analogue glargine instead of human insulin. Scientists analysed the data of almost 130,000 patients with diabetes in Germany who had been treated with either human insulin or the insulin analogues lispro, aspart or glargine between January 2001 and June 2005.

The risk of cancer possibly increases if patients with diabetes use the long-acting insulin analogue glargine instead of human insulin. The Institute for Quality and Efficiency in Health Care (IQWiG), in collaboration with the "Wissenschaftliches Institut der AOK" (WIdO), the research institute of the German Local Health Care Fund, analysed the data of almost 130,000 patients with diabetes in Germany who had been treated with either human insulin or the insulin analogues lispro (trade name: Humalog), aspart (Novorapid) or glargine (Lantus) between January 2001 and June 2005.

The analysis has now been published together with further studies in the scientific journal Diabetologia.

The disturbing result is that malignancies were found more frequently in patients treated with glargine than in those prescribed a comparable dose of human insulin. "Our analysis does not provide absolute proof that glargine promotes cancer," says Peter T. Sawicki, IQWiG's Director and co-author of the study. "Our study does, however, arouse an urgent suspicion which should have consequences for the treatment of patients."

No difference was found between the short-acting insulin analogues, lispro and aspart, and human insulin. Insulin analogues are synthetic molecules that do not occur naturally, whereas human insulin matches the insulin that the human body manufactures itself.

Is glargine the cause?

IQWiG emphasises that the link found between prescribing glargine and an increased cancer risk is a statistical association. Thus, it is possible that other factors as yet unknown are the cause of the increased risk, rather than glargine. However, it is disturbing that of three further studies published in the same edition of Diabetologia, two also describe an increase in cancer risk associated with glargine.

Glargine has been approved in Germany since 2000. Since then, several laboratory trials have been published which indicate that, under certain conditions, insulin analogues can stimulate the growth of cancer cell lines more strongly than human insulin. "These indications are discussed in the scientific world but have never been dispelled by proper studies," says Sawicki. According to IQWiG, the overall indications of a risk from glargine have now intensified to such an extent that the burden of proof has been reversed for precautionary reasons: as long as reliable studies do not prove the safety of glargine compared to human insulin, the drug should only be used if there are particularly important reasons for doing so.

Risk of disease increases with dose

The researchers also found that the risk of cancer rose further with increasing glargine dose when compared to human insulin. This dose-dependent relationship with glargine also confirms the suspicion that the drug plays a causal role.

The increase in cancer risk was relatively small and was only detected when other, important factors such as age, sex and daily insulin dose were taken into consideration. The patients were on average between 65 and 70 years of age, thus in principle were already exposed to a certain degree of cancer risk. Out of 1000 patients treated with human insulin, about 41 developed malignancies within an average of 20 months. If "similar" patients were to be treated with glargine, the increases in cancer diagnoses would be as follows: in patients prescribed on average 10 glargine units daily, about 4 more patients per 1000 patients would develop cancer. In patients prescribed 50 glargine units daily, about 13 more patients per 1000 patients would develop cancer.

However, according to the German Local Health Care Fund data, most patients used glargine in relatively low doses. Of 100 patients using glargine, about 50 patients used less then 20 units daily, and only 5 of 100 patients used more than 50 units daily.

Don't change treatment hastily

However, the latest investigation is no reason for patients with diabetes to change their treatment hastily, especially if the glargine dose used is low. Diabetes is a complex disease and many aspects need to be considered in its treatment. "However, if a patient can be treated equally well with human insulin as with glargine, then, after consultation with his or her doctor, the patient should consider changing to human insulin," states Sawicki. "If at all possible, patients with an increased risk of cancer should use human insulin instead of glargine."

The researchers have no evidence that glargine or other insulin agents transform normal cells to cancer cells. However, it may be possible that glargine stimulates the growth of existing cancer cells more strongly than other types of insulin.

In their study, IQWiG and WIdO had access to pseudonymous data on disease and invoices for 17.9 million insurants of the AOK, of which over 320,000 patients had diabetes (particularly type 2). The data were evaluated of approximately 130,000 patients with diabetes who had used either human insulin or an insulin analogue exclusively, and who had not developed malignancies up to 2001.


Story Source:

The above story is based on materials provided by Institute for Quality and Efficiency in Health Care. Note: Materials may be edited for content and length.


Cite This Page:

Institute for Quality and Efficiency in Health Care. "Insulin Analogue Glargine Possibly Increases Cancer Risk." ScienceDaily. ScienceDaily, 29 June 2009. <www.sciencedaily.com/releases/2009/06/090626190935.htm>.
Institute for Quality and Efficiency in Health Care. (2009, June 29). Insulin Analogue Glargine Possibly Increases Cancer Risk. ScienceDaily. Retrieved August 1, 2014 from www.sciencedaily.com/releases/2009/06/090626190935.htm
Institute for Quality and Efficiency in Health Care. "Insulin Analogue Glargine Possibly Increases Cancer Risk." ScienceDaily. www.sciencedaily.com/releases/2009/06/090626190935.htm (accessed August 1, 2014).

Share This




More Health & Medicine News

Friday, August 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

House Republicans Vote to Sue Obama Over Healthcare Law

House Republicans Vote to Sue Obama Over Healthcare Law

Reuters - US Online Video (July 31, 2014) The Republican-led House of Representatives votes to sue President Obama, accusing him of overstepping his executive authority in making changes to the Affordable Care Act. Mana Rabiee reports. Video provided by Reuters
Powered by NewsLook.com
Despite Health Questions, E-Cigs Are Beneficial: Study

Despite Health Questions, E-Cigs Are Beneficial: Study

Newsy (July 31, 2014) Citing 81 previous studies, new research out of London suggests the benefits of smoking e-cigarettes instead of regular ones outweighs the risks. Video provided by Newsy
Powered by NewsLook.com
Dangerous Bacteria Kills One in Florida

Dangerous Bacteria Kills One in Florida

AP (July 31, 2014) Sarasota County, Florida health officials have issued a warning against eating raw oysters and exposing open wounds to coastal and inland waters after a dangerous bacteria killed one person and made another sick. (July 31) Video provided by AP
Powered by NewsLook.com
Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins