Reports from the European Association for the Study of Diabetes and the International Thyroid Congress

Web Exclusives
Jill Stein

STOCKHOLM—New data undermine the widely held notion that the greater likelihood of cancer seen in diabetic patients on insulin therapy increases with longer insulin use.

In fact, the findings, reported at the 46th European Association for the Study of Diabetes meeting, show that the increased cancer risk in diabetes drops substantially with long-term insulin use.

Daniel Witte, MD, PhD, research group leader at the Steno Diabetes Center in Gentofte, Denmark, and colleagues tracked the entire Danish population of 5.5 million people over 13 years to assess the association between length of insulin use and cancer incidence. The Steno Diabetes Center is owned by Novo Nordisk.

Over the past several decades, numerous studies have found elevated rates of cancer of the liver, kidney, female breast, and corpus uteri in diabetic patients.

The new study confirmed that there is an excess cancer risk in patients with diabetes and also that insulin-using diabetics have a higher cancer risk than diabetics not using insulin. For example, 20.9% of nondiabetic Danish men 65 years of age and older are likely to develop cancer over the next 10 years compared with 22.3% of diabetic men not using insulin and 23.7% of diabetic men using insulin. The corresponding figures for women are 15.4%, 16.1%, and 19.5%.

For all cancer types combined, the effect of insulin use was highest immediately after the start of treatment and decreased to a stable level 3 to 4 years after the first insulin prescription. This pattern was also seen for the duration of diabetes, with the risk being highest in the period just after diagnosis and decreasing to a point where the patient had no excess risk after 3 years.

The investigators say that theirs is the largest registry linkage study to date to focus on diabetes.

The investigators noted that their results suggest that it may not be duration or insulin that carries the risk. Instead the risk may be partly due to causes common to cancer and diabetes/insulin treatment, such as obesity.

Thyroid Cancer Patients Embrace Unconventional Treatments
PARIS—Most patients with thyroid cancer report that they used some form of complementary and alternative medicine (CAM) over the past 12 months, re searchers reported at the 14th In - ternational Thyroid Congress.

Jennifer E. Rosen, MD, assistant professor of surgery at Boston University School of Medicine, Massachusetts, and colleagues analyzed responses to an online questionnaire on CAM use that was completed by 1324 patients who belonged to a thyroid cancer survivors’ organization.

The survey found that 80% of patients said they had used some form of CAM therapy during the past 12 months and that only 6.6% of respondents said that they did not use any form of CAM.

The two most commonly used CAM therapies were prayer (35.3%) and multivitamins (41.8%). When prayer and multivitamins were excluded from the analysis, 67.5% of patients used some form of CAM therapy during the past 12 months.

After prayer and multivitamins, the five most commonly used CAM practice therapies were massage therapy, chiropractic therapy, yoga, meditation, and acupuncture. The five most commonly used CAM biologic therapies were herbal tea, special diets, herbal supplements, homeopathy, and ginger.

CAM therapies were most often used for the treatment of symptoms (69.1%), but a high percentage of patients used CAM as part of their thyroid cancer treatment (30.9%). More than half of patients (54.2%) said that they had used CAM more than 10 times in the past 12 months.

About two thirds of patients believed that CAM treatments were helpful, and about one third believed that they had no effect. Nearly 20% of respondents reported that their physician did not know that they were using CAM therapies and had not inquired about CAM use.

Overall, the results demonstrate that the rate of CAM use in thyroid cancer patients is twice that reported from national surveys of the general US population.

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Last modified: April 27, 2020