Oral Insulin Secretagogues and Cancer Risk in Type 2 Diabetes Mellitus: An Updated Review

Chia-Hsuin Chang ； Lee-Ming Chuang

《Formosan Journal of Endocrinology and Metabolism》 5卷S期 (2014/05) Pp. 15-22

https://doi.org/10.6856/FJEM.201405_5(S).0003

摘要

Background. Compelling evidence shows that there is an association between type 2 diabetes and several types of cancers. Although the underlying mechanisms remain largely unknown, hyperinsu-linemia, along with insulin resistance, appear to be a possible link between type 2 diabetes and cancer risk. Oral insulin secretagogues (including sulfonylureas and glinides) might pose potential cancer risk because these agents increase plasma insulin levels. However, different insulin secretagogues affect plasma insulin differently. The association between oral insulin secretagogues and cancer risk might be related to potency to stimulate endogenous insulin secretion. Findings. Several epidemiological studies indicate that sulfonylurea and glinides could increase the overall cancer risk and the risk of certain specific cancers in type 2 diabetic patients to a degree lesser extent than insulin. On the contrary, antihyperglycemic agents that do not increase insulin levels (such as metformin and thiazolidinediones) seem to be associated with a decreased cancer risk. Conclusion. At present, there are no definitive prospective data on the cancer risk from diabetes drugs. Large randomized controlled trials and well-designed observational studies are required for evaluation of long-term cancer risk associated with oral insulin secretagogues.

關鍵字

drug safety ； neoplasms ； sulfonylurea compounds ； type 2 diabetes