Is there a link between high insulin dosage and cancer?

By ASCO Postal Staff

Published: 03/08/2022 13:05:00

Last update: 03/08/2022 13:43:49


A study investigating the correlation between daily insulin dose and cancer incidence in patients with type 1 diabetes found that higher insulin dose is positively associated with cancer incidence and that the association is stronger in people with insulin resistance. The results were published by Zhong and Mao as a research letter in JAMA Oncology.

Study details

“In patients with type 1 diabetes, our results show that traditional metabolic factors such as obesity (represented by body mass index), sugar control (represented by hemoglobin A1c) and control blood pressure are not associated with cancer incidence,” the co-author said. Yuanjie Mao, MD, Ph.D., of the Diabetes Institute, Ohio University, Athens, who conducted the study. “However, cancer incidence was higher in those who took higher doses of insulin. Our results implied that clinicians may need to balance the potential risk of cancer when treating patients with diabetes of type 1 with a high daily insulin dose or that improving insulin sensitivity may be preferred to simply increasing the insulin dose.

Dr. Mao collaborated with Wenjun Zhong, PhD, an epidemiologist at Merck Research Labs in West Point, Pennsylvania, to explore associations of more than 50 common risk factors (eg, smoking, alcohol consumption, exercise, metabolic risk factors, use medications and family history) with cancer incidence in 1,303 patients with type 1 diabetes whose data were collected over 28 years. They performed a statistical analysis of data acquired from the Diabetes Control and Complications Trial (DCCT) and its follow-up, the Epidemiology of Diabetes Interventions and Complications study, conducted by the National Diabetes Institute and Digestive and Kidney Diseases Central Repository. The DCCT was a controlled clinical trial that included 1,441 patients with type 1 diabetes who were randomly assigned to receive conventional antidiabetic therapy or intensive therapy, to assess whether reducing high blood sugar would reduce the risk of complications of type 1 diabetes.

Additional Findings

The researchers also found that age and sex are associated with cancer incidence when assessed separately and that a daily dose of insulin poses a higher cancer risk than age, particularly a higher insulin dose. According to the article, when the daily insulin dose is classified into three groups: low (

Dr. Mao went on to explain that, specifically, women are at higher risk than men. However, it was unclear which risk factors may contribute to the higher incidence of cancer in type 1 diabetics.

Although previous studies have concluded that patients with diabetes have a higher risk of cancer in general, this is the first study to explore cancer incidence factors associated with type 1 diabetes.

“Type 1 diabetes accounts for about 5-10% of all diabetes cases, and recent studies of type 1 diabetes have also found a higher incidence of certain cancers such as stomach cancer, liver cancer , pancreas, endometrium, and kidney in the population compared with the general population,” Dr. Mao noted. “In type 2 diabetes, the increased risk is attributed to metabolic factors such as obesity. , chronic inflammatory state and insulin resistance.”

Although the study results suggest that the higher the insulin dose, the higher the incidence of cancer, Dr. Mao says further investigation is still needed.

The content of this article has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the views and opinions of ASCO®.


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