Association between severity of diabetic complications and risk of cancer in middle‐aged patients with type 2 diabetes

ABSTRACT Aim Hyperglycemia was found to be associated with an increased risk of cancer in a general population cohort. However, it remains to be established whether the severity of diabetic complications is associated with cancer risk in patients with diabetes. Materials and Methods We used the Nati...

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Main Authors: Yao‐Hsien Tseng, Yu‐Tse Tsan, Pau‐Chung Chen
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Journal of Diabetes Investigation
Subjects:
Online Access:https://doi.org/10.1111/jdi.14364
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author Yao‐Hsien Tseng
Yu‐Tse Tsan
Pau‐Chung Chen
author_facet Yao‐Hsien Tseng
Yu‐Tse Tsan
Pau‐Chung Chen
author_sort Yao‐Hsien Tseng
collection DOAJ
description ABSTRACT Aim Hyperglycemia was found to be associated with an increased risk of cancer in a general population cohort. However, it remains to be established whether the severity of diabetic complications is associated with cancer risk in patients with diabetes. Materials and Methods We used the National Health Insurance Research Database from 2000 through 2013, including those with newly diagnosed diabetic patients (n = 616,742). We collected all vascular and metabolic complications to develop an adapted diabetic complication severity index (aDCSI), ranging from 0 to 13 annually, as proxies of the severity of diabetic complications and performed follow‐up from the onset of diabetes until incident cancer, death, or the study end. Results Within the mean follow‐up period of 9 years, the rates of cancer incidence per 100,000 person‐years were 815.2 vs 482.0 and 611.1 vs 358.9 for the top vs bottom quartiles, respectively, of aDCSI in men and women (adjusted HRs 1.17 (95% CI 1.10–1.25) and 1.20 (95% CI 1.10–1.30), respectively). The risk of cancer was 1.7‐ to 1.9‐fold for the top vs bottom quartiles of aDCSI in diabetic onset age of 40–44 (HRs 1.74 (95% CI, 1.39–2.18) in men and HRs 1.93 (95% CI, 1.39–2.66) in women). However, among patients with diabetic onset age of 60–64, the associations between the severity of diabetic complications and cancer risk were attenuated. Conclusions Patients with higher severity of diabetic complications have an increased risk of cancer compared to those with the lowest severity, particularly for those with earlier onset and greater severity of diabetic complications.
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spelling doaj-art-8b4e1c8633ee4c68a1566f7d2205e27a2025-01-02T04:44:54ZengWileyJournal of Diabetes Investigation2040-11162040-11242025-01-01161162410.1111/jdi.14364Association between severity of diabetic complications and risk of cancer in middle‐aged patients with type 2 diabetesYao‐Hsien Tseng0Yu‐Tse Tsan1Pau‐Chung Chen2Department of Post‐Baccalaureate Medicine National Chung Hsing University Taichung TaiwanDivision of Occupational Medicine, Department of Emergency Medicine Taichung Veterans General Hospital Taichung TaiwanInstitute of Environmental and Occupational Health Sciences National Taiwan University Taipei TaiwanABSTRACT Aim Hyperglycemia was found to be associated with an increased risk of cancer in a general population cohort. However, it remains to be established whether the severity of diabetic complications is associated with cancer risk in patients with diabetes. Materials and Methods We used the National Health Insurance Research Database from 2000 through 2013, including those with newly diagnosed diabetic patients (n = 616,742). We collected all vascular and metabolic complications to develop an adapted diabetic complication severity index (aDCSI), ranging from 0 to 13 annually, as proxies of the severity of diabetic complications and performed follow‐up from the onset of diabetes until incident cancer, death, or the study end. Results Within the mean follow‐up period of 9 years, the rates of cancer incidence per 100,000 person‐years were 815.2 vs 482.0 and 611.1 vs 358.9 for the top vs bottom quartiles, respectively, of aDCSI in men and women (adjusted HRs 1.17 (95% CI 1.10–1.25) and 1.20 (95% CI 1.10–1.30), respectively). The risk of cancer was 1.7‐ to 1.9‐fold for the top vs bottom quartiles of aDCSI in diabetic onset age of 40–44 (HRs 1.74 (95% CI, 1.39–2.18) in men and HRs 1.93 (95% CI, 1.39–2.66) in women). However, among patients with diabetic onset age of 60–64, the associations between the severity of diabetic complications and cancer risk were attenuated. Conclusions Patients with higher severity of diabetic complications have an increased risk of cancer compared to those with the lowest severity, particularly for those with earlier onset and greater severity of diabetic complications.https://doi.org/10.1111/jdi.14364Cancer riskSeverity of diabetic complicationsType 2 diabetes mellitus
spellingShingle Yao‐Hsien Tseng
Yu‐Tse Tsan
Pau‐Chung Chen
Association between severity of diabetic complications and risk of cancer in middle‐aged patients with type 2 diabetes
Journal of Diabetes Investigation
Cancer risk
Severity of diabetic complications
Type 2 diabetes mellitus
title Association between severity of diabetic complications and risk of cancer in middle‐aged patients with type 2 diabetes
title_full Association between severity of diabetic complications and risk of cancer in middle‐aged patients with type 2 diabetes
title_fullStr Association between severity of diabetic complications and risk of cancer in middle‐aged patients with type 2 diabetes
title_full_unstemmed Association between severity of diabetic complications and risk of cancer in middle‐aged patients with type 2 diabetes
title_short Association between severity of diabetic complications and risk of cancer in middle‐aged patients with type 2 diabetes
title_sort association between severity of diabetic complications and risk of cancer in middle aged patients with type 2 diabetes
topic Cancer risk
Severity of diabetic complications
Type 2 diabetes mellitus
url https://doi.org/10.1111/jdi.14364
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