Evidence map›Paper›PMID 26575601›Full record

ArticleBritish journal of cancer2015

New-onset type 2 diabetes, elevated HbA1c, anti-diabetic medications, and risk of pancreatic cancer.

Yunxia Lu, Luis Alberto García Rodríguez, Linnéa Malgerud, Antonio González-Pérez, Mar Martín-Pérez, Jesper Lagergren, Tomas S Bexelius

Open access · hybridAbstract read
In one paragraph

Article in British journal of cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 4 pooled it
3.3field-weighted citation impact, top 7% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 82 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 3 countries.

Yunxia LuDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm 171 76, Sweden.
Luis Alberto García RodríguezCentro Español de Investigación Farmacoepidemiológica, Madrid 28004, Spain.
Linnéa MalgerudDepartment of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm 171 77, Sweden.
Antonio González-PérezCentro Español de Investigación Farmacoepidemiológica, Madrid 28004, Spain.
Mar Martín-PérezCentro Español de Investigación Farmacoepidemiológica, Madrid 28004, Spain.
Jesper LagergrenDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm 171 76, Sweden.
Tomas S BexeliusDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm 171 76, Sweden.
Karolinska Institutet · SECentro Español de Investigación Farmacoepidemiológica · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAssociations between type 2 diabetes, anti-diabetic medications and pancreatic cancer are controversial. This study aims to clarify such associations with new-onset type 2 diabetes and repeated measurements of glycated haemoglobin (HbA1c) levels.

methodsA nested case-control study was initiated from the Health Improvement Network (THIN) in UK from 1996 to 2010. Information of pancreatic cancer cases was retrieved electronically from the medical records and manually validated. Control subjects were randomly selected and frequency-matched to the cases on sex, age, and calendar years. Multivariable unconditional logistic regression was performed to estimate odds ratios (OR) and 95% confidence intervals (CI), and adjusted for potential confounders.

resultsAmong 1,574,768 person-years of follow-up, 529 pancreatic cancer cases and 5000 controls were identified. Type 2 diabetes, or changed HbA1c levels (rather than HbA1c levels at diabetes diagnosis) in diabetes patients (⩾4 mmol mol(-1) compared with <0 mmol mol(-1)) were followed by an increased OR of pancreatic cancer (OR, 2.16, 95% CI 1.72-2.72 and OR, 5.06, 95% CI 1.52-16.87, respectively). Among the anti-diabetic medications in diabetes patients, the OR for insulin users was 25.57 (95% CI 11.55-56.60), sulphonylureas 2.22 (95% CI 1.13, 4.40), and metformin users 1.46 (95% CI 0.85-2.52), compared with no use of any anti-diabetic medications.

conclusionsNew-onset type 2 diabetes and, particularly, diabetes with rising HbA1c seem to be independent risk factors for pancreatic cancer. The relation between different anti-diabetic medications and pancreatic cancer seems to vary in strength, with the highest risk among users of insulin.

Indexed as

AgedCase-Control StudiesDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHumansHypoglycemic AgentsIncidenceInsulinMaleMetforminMiddle AgedPancreatic NeoplasmsRisk FactorsSulfonylurea CompoundsTime FactorsGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulinMetforminSulfonylurea Compounds

Identifiers

PMID26575601
PMCPMC4705881
OpenAlexW2202568972

What Socratic holds

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

Registered trials

None linked

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.