Insulin Therapy and Colorectal Adenomas in Patients with Type 2 Diabetes Mellitus
Cancer Epidemiology, Biomarkers & Prevention, 08/10/2012
Wong P et al. – Chronic insulin therapy is associated with increased risk of colorectal adenomas in patients with type 2 diabetes. Diabetes patients receiving insulin may need more stringent colon cancer screening.Methods
- The authors conducted a cross-sectional study of type 2 diabetic patients between the ages of 50 and 80years who completed full colonoscopies.
- Cases were patients with any adenoma on index colonoscopy.
- Patients without any adenoma compose the control group.
- Multivariable logistic regression was used to calculate odds ratios (ORs) and associated confidence intervals (CIs).
- Compared to the controls, case patients (n=196) did not have a significantly increased odds of insulin exposure, when exposure was defined as ≥12months of insulin use compared to no insulin.
- However, the odds of insulin exposure among the cases was significantly increased when exposure was defined as ≥18months (OR 1.6, 95% CI 1.1-2.5), ≥24months (OR 1.7, CI 1.1-2.6), and ≥36months (OR 2.0, 95% CI 1.2-3.4) of insulin use (test for trend p=0.05).
- A similar trend in insulin exposure was seen among type 2 diabetics with advanced adenomas.
- Adenoma location was not significantly affected by insulin therapy.