Patients with cancer may be at a significantly higher risk of developing diabetes, according to a study published in JAMA Oncology.1
Diabetes is a comorbid condition that significantly affects the quality of life among patients with cancer and has been identified as a risk factor for the development of cardiovascular disease. It is also the main cause of noncancer mortality among survivors of cancer and is related to increased mortality in patients living with cancer. Many studies have suggested that diabetes is a risk factor for the development of cancer, but whether or not cancer itself can increase the risk of diabetes requires further investigation.
For this large retrospective South Korean cohort study, researchers accessed the National Health Insurance Service–National Sample Cohort (NHIS-NSC) to evaluate the outcomes of 494,189 patients. Patients who underwent at least one health screening examination that included assessments of cardiovascular and diabetes risk factors and did not have diabetes or history of cancer at baseline were eligible for the study.
The median follow-up of the study was 7.0 years, which accounted for 3,492,935.6 person-years of follow-up. Of the study participants, 15,130 developed cancer and 26,610 participants developed diabetes.
Upon multivariate analyses adjusting for age, sex, comorbidities, metabolic factors, and precancer diabetes risk factors, results showed that the risk of developing diabetes was increased with cancer development (hazard ratio [HR], 1.35; 95% CI, 1.26-1.45; P < .001). The first 2-years post-diagnosis had the highest risk of disease development, but risk remained elevated throughout the follow-up period.
A number of cancers were significantly associated with the increased risk of diabetes, including pancreatic, kidney, liver, gallbladder, lung, blood, breast, stomach, and thyroid cancers.
The authors concluded that “these data provide evidence that cancer is associated with an increased risk of diabetes in cancer survivors independent of traditional diabetes risk factors. Physicians should remember that patients with cancer develop other clinical problems, such as diabetes, with higher frequency than individuals without cancer, and should consider routine diabetes screening in these patients.”
- Hwangbo Y, Kang D, Kang M, et al. Incidence of diabetes after cancer development [published online June 7, 2018]. JAMA Oncol. doi:10.1001/jamaoncol.2018.1684