Evidence map›Paper›PMID 19918015›Full record

ArticleDiabetes care2010

Metformin associated with lower cancer mortality in type 2 diabetes: ZODIAC-16.

Gijs W D Landman, Nanne Kleefstra, Kornelis J J van Hateren, Klaas H Groenier, Rijk O B Gans, Henk J G Bilo

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes care, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04626089 (Adaptive Study for Efficacy and Safety of Metformin Glycinate for the Treatment of Patients With MS and DM2, Hospitalized With Severe Acute Respiratory Syndrome Secondary to SARS-CoV-2. Randomized, Double-Blind, Phase IIIb.), which is not on this map. Cited by 219 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
219citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04626089 phase2withdrawnstarted 2021, after this paper: background citation

Adaptive Study for Efficacy and Safety of Metformin Glycinate for the Treatment of Patients With MS and DM2, Hospitalized With Severe Acute Respiratory Syndrome Secondary to SARS-CoV-2. Randomized, Double-Blind, Phase IIIb.

Ran2021Enrolled0Registered outcomes12Posted comparisons0ConditionsMetabolic Syndrome, Severe Acute Respiratory Syndrome Coronavirus 2, Type 2 DiabetesArmsMetformin glycinate, Placebo Oral Tablet
PMID 7996443PMID 30414960PMID 22974412PMID 17941868PMID 9030834PMID 19538242PMID 7623903PMID 8269798PMID 2648723PMID 12086935PMID 20577053PMID 16308421other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

219 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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  16. Metformin does not reduce markers of cell proliferation in esophageal tissues of patients with Barrett's esophagus.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2015
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159 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Gijs W D LandmanInternal Medicine, Isala Clinics, Zwolle, The Netherlands. g.w.d.landman@isala.nl
Nanne Kleefstra
Kornelis J J van Hateren
Klaas H Groenier
Rijk O B Gans
Henk J G Bilo

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSeveral studies have suggested an association between specific diabetes treatment and cancer mortality. We studied the association between metformin use and cancer mortality in a prospectively followed cohort. RESEARCH DESIGN AND

methodsIn 1998 and 1999, 1,353 patients with type 2 diabetes were enrolled in the Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) study in the Netherlands. Vital status was assessed in January 2009. Cancer mortality rate was evaluated using standardized mortality ratios (SMRs), and the association between metformin use and cancer mortality was evaluated with a Cox proportional hazards model, taking possible confounders into account.

resultsMedian follow-up time was 9.6 years, average age at baseline was 68 years, and average A1C was 7.5%. Of the patients, 570 died, of which 122 died of malignancies. The SMR for cancer mortality was 1.47 (95% CI 1.22-1.76). In patients taking metformin compared with patients not taking metformin at baseline, the adjusted hazard ratio (HR) for cancer mortality was 0.43 (95% CI 0.23-0.80), and the HR with every increase of 1 g of metformin was 0.58 (95% CI 0.36-0.93).

conclusionsIn general, patients with type 2 diabetes are at increased risk for cancer mortality. In our group, metformin use was associated with lower cancer mortality compared with nonuse of metformin. Although the design cannot provide a conclusion about causality, our results suggest a protective effect of metformin on cancer mortality.

Indexed as

AgedBlood PressureBody Mass IndexCohort StudiesDiabetes Mellitus, Type 2Diabetic AngiopathiesFemaleGlycated HemoglobinHumansHypertensionHypoglycemic AgentsInsulinMaleMetforminMiddle AgedNeoplasmsGlycated HemoglobinHypoglycemic AgentsInsulinMetformin

Identifiers

PMID19918015
PMCPMC2809274

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.