SynthesisScientific reports2015
Pharmacologic Therapy of Diabetes and Overall Cancer Risk and Mortality: A Meta-Analysis of 265 Studies.
Synthesis in Scientific reports, 2015. The graph read 15 numbers from its abstract, feeding 10 cells of the map, but none could be read as for or against, so it casts no vote. It also reports 5 associations that do not count as treatment evidence, such as RR 0.86 (0.83 to 0.90) for adverse events & safety. Cited by 76 papers, 10 of them syntheses that pooled 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.
Read, but not usablea number the graph found but could not read as for or against
For GLP-1 agonist use, meta-analysis of 16 studies demonstrated no significant association with cancer risk (RR = 1.12, 95% CI 0.61-2.06) (Table 1h).
Dapagliflozin was not associated with the risk of cancer (7 studies, RR = 0.90, 95% CI 0.49-1.65) (Table 1i).
On the other hand, we did not detect significant association between sulfonylureas use and cancer mortality (12 studies, RR = 1.08, 95% CI 0.99-1.18) (Table 2c).
Meta-analysis demonstrated that the use of metformin or thiazolidinediones was associated with a lower risk of cancer incidence (RR = 0.86, 95% CI 0.83-0.90, I(2) = 88.61%; RR = 0.93, 95% CI 0.91-0.96, I(2) = 0.00% respectively).
Meta-analysis demonstrated that the use of metformin or thiazolidinediones was associated with a lower risk of cancer incidence (RR = 0.86, 95% CI 0.83-0.90, I(2) = 88.61%; RR = 0.93, 95% CI 0.91-0.96, I(2) = 0.00% respectively).
Meta-analysis of 62 studies showed that DPP-4 inhibitors were not associated with the risk of cancer (RR = 0.92, 95% CI 0.82-1.04) (Table 1e).
On the other hand, insulin, sulfonylureas and alpha glucosidase inhibitor use was associated with an increased risk of cancer incidence (RR = 1.21, 95% CI 1.08-1.36, I(2) = 96.31%; RR = 1.20, 95% CI 1.13-1.27, I(2) = 95.02%; RR = 1.10, 95% CI 1.05-1.15, I(2) = 0.00% respectively).
On the other hand, insulin, sulfonylureas and alpha glucosidase inhibitor use was associated with an increased risk of cancer incidence (RR = 1.21, 95% CI 1.08-1.36, I(2) = 96.31%; RR = 1.20, 95% CI 1.13-1.27, I(2) = 95.02%; RR = 1.10, 95% CI 1.05-1.15, I(2) = 0.00% respectively).
On the other hand, insulin, sulfonylureas and alpha glucosidase inhibitor use was associated with an increased risk of cancer incidence (RR = 1.21, 95% CI 1.08-1.36, I(2) = 96.31%; RR = 1.20, 95% CI 1.13-1.27, I(2) = 95.02%; RR = 1.10, 95% CI 1.05-1.15, I(2) = 0.00% respectively).
Insulin use was significantly associated with an increased risk of cancer (73 studies; RR = 1.21, 95% CI 1.08-1.36) (Table 1a).
With regard to cancer mortality, we did not detect significant association with insulin use (12 studies; RR = 1.19, 95% CI 0.80-1.77) (Table 2a).
Meta-analysis of 66 and 12 studies respectively, demonstrated significant association between the use of metformin and the risk of cancer (RR = 0.86, 95% CI 0.83-0.90) and cancer mortality (RR = 0.70, 95% CI 0.53-0.94) (Table 1b and 2b).
Use of sulfonylureas was associated with an increased risk of cancer (72 studies, RR = 1.20, 95% CI 1.13-1.27) (Table 1c).
Similar to the case of metformin, TZD use was associated with a decreased risk of cancer (119 studies, RR = 0.93, 95% CI 0.91-0.96) (Table 1d).
Alpha glucosidase inhibitor use was associated with increased risk of cancer (13 studies, RR = 1.10, 95% CI 1.05-1.15) (Table 2f).
clause the extractor read what became the number
Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
DPP-4 inhibitors×adverse events & safety
No readable resultOpen on the map →What to test next →34 readable studies in this cell: 12 favour the treatment, 17 find no difference, 5 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
GLP-1 receptor agonists×adverse events & safety
No readable resultOpen on the map →What to test next →40 readable studies in this cell: 47 favour the treatment, 14 find no difference, 2 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Insulin×glycemic control
No readable resultOpen on the map →What to test next →40 readable studies in this cell: 15 favour the treatment, 14 find no difference, 14 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Metformin×adverse events & safety
No readable resultOpen on the map →What to test next →22 readable studies in this cell: 9 favour the treatment, 8 find no difference, 5 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Other glucose-lowering×glycemic control
No readable resultOpen on the map →What to test next →8 readable studies in this cell: 5 favour the treatment, 0 find no difference, 3 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Other glucose-lowering×adverse events & safety
No readable resultOpen on the map →What to test next →3 readable studies in this cell: 0 favour the treatment, 1 find no difference, 2 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
SGLT2 inhibitors×adverse events & safety
No readable resultOpen on the map →What to test next →38 readable studies in this cell: 18 favour the treatment, 19 find no difference, 1 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Sulfonylureas & glinides×adverse events & safety
No readable resultOpen on the map →What to test next →8 readable studies in this cell: 1 favour the treatment, 6 find no difference, 1 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Sulfonylureas & glinides×glycemic control
No readable resultOpen on the map →What to test next →31 readable studies in this cell: 7 favour the treatment, 13 find no difference, 11 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Thiazolidinediones×adverse events & safety
No readable resultOpen on the map →What to test next →6 readable studies in this cell: 3 favour the treatment, 2 find no difference, 1 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 10 syntheses or guidelines pooled it, 143 citations in OpenAlex.
- Treatment Effects in Randomized and Nonrandomized Studies of Pharmacological Interventions: A Meta-Analysis.JAMA network open · 2024Pooled it
- Diabetes medications and cancer risk associations: a systematic review and meta-analysis of evidence over the past 10 years.Scientific reports · 2023Pooled it
- American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022Guideline
- Association of diabetes mellitus with thyroid cancer risk: A meta-analysis of cohort studies.Medicine · 2017Pooled it
- Breastfeeding and thyroid cancer risk in women: A dose-response meta-analysis of epidemiological studies.Clinical nutrition (Edinburgh, Scotland) · 2016Pooled it
- Parity and thyroid cancer risk: a meta-analysis of epidemiological studies.Cancer medicine · 2016Pooled it
- Statin use and breast cancer survival and risk: a systematic review and meta-analysis.Oncotarget · 2015Pooled it
- Efficacy of Ligustrazine Injection as Adjunctive Therapy for Angina Pectoris: A Systematic Review and Meta-Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2015Pooled it
- Cyclooxygenase-2-1195G>A Polymorphism and Head and Neck Squamous Cell Carcinoma Susceptibility: A Meta-Analysis of 1564 Cases and 2346 Controls.Medical science monitor : international medical journal of experimental and clinical research · 2015Pooled it
- Parity and endometrial cancer risk: a meta-analysis of epidemiological studies.Scientific reports · 2015Pooled it
- Diabetes mellitus in multiple myeloma and related plasma cell disorders: a review of risk, prognosis, and outcomes.Blood cancer journal · 2026Review
- DPP-4 Inhibitors in Female Cancers: Opportunities for Drug Repurposing.Current issues in molecular biology · 2026Review
- Bifunctional Metformin-Phenolic Hybrids with Improved Anticancer and Antioxidant Properties: Evaluation on Glioma Cells.International journal of molecular sciences · 2026Article
- The therapeutic value of antidiabetic drugs in lung cancer treatment: from clinical evidence to possible mechanisms.Frontiers in immunology · 2026Review
- Association between antidiabetic drugs and cancer risk in patients with type 2 diabetes mellitus: A systematic review and network meta-analysis.World journal of diabetes · 2025Article
- Pan-cancer analysis and oncogenic implications ofJournal of cell communication and signaling · 2025Article
- Assessment of cancer risk associated with 7-nitroso-3-(trifluoromethyl)-5,6,7,8-tetrahydro[1,2,4] triazolo-[4,3-a]pyrazine-contaminated sitagliptin use: A retrospective cohort study.Journal of diabetes investigation · 2024Article
- Article
- Associations between Diabetes Mellitus and Selected Cancers.International journal of molecular sciences · 2024Review
- Cancer biology in diabetes update: Focusing on antidiabetic drugs.Journal of diabetes investigation · 2024Review
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
Different anti-diabetic medications (ADMs) may modify cancer risk and mortality in patients with diabetes. We conducted a systematic review and meta-analysis to estimate the magnitude of association and quality of supporting evidence for each ADM. A total of 265 studies (44 cohort studies, 39 case-control studies, and 182 randomized controlled trials (RCT)) were identified, involving approximately 7.6 million and 137,540 patients with diabetes for observational studies and RCTs, respectively. The risk of bias overall was moderate. Meta-analysis demonstrated that the use of metformin or thiazolidinediones was associated with a lower risk of cancer incidence (RR = 0.86, 95% CI 0.83-0.90, I(2) = 88.61%; RR = 0.93, 95% CI 0.91-0.96, I(2) = 0.00% respectively). On the other hand, insulin, sulfonylureas and alpha glucosidase inhibitor use was associated with an increased risk of cancer incidence (RR = 1.21, 95% CI 1.08-1.36, I(2) = 96.31%; RR = 1.20, 95% CI 1.13-1.27, I(2) = 95.02%; RR = 1.10, 95% CI 1.05-1.15, I(2) = 0.00% respectively). Use of other types of ADMs was not significantly associated with cancer risk. This study indicates that some ADMs may modify the risk of cancer in individuals with diabetes. Knowledge of this risk may affect the choice of ADM in individuals concerned about cancer or at increased risk for cancer.
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What Socratic holds
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.