Cancer Risk From Diabetes Drugs Unproven
There is insufficient evidence linking glucose-lowering medications with an increased risk for cancer, and clinicians can continue to “confidently” prescribe all such Food and Drug Administration (FDA)–approved agents for the management of hyperglycemia, the American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) say in a joint consensus statement released yesterday.
For most people with diabetes, the benefits of treatment should take precedence over concerns for potential low-grade cancer risk until more definitive evidence becomes available.
However, the group also recommends that physicians should “exercise caution when choosing medications implicated in the etiology of cancer for patients with the specific organ-related risk.”
Recent concern has emerged regarding links between diabetes drugs and cancer. In particular, debate has surrounded both a possible link between incretin drugs and pancreatic cancer and between basal insulin glargine (Lantus, Sanofi) and cancer.
But, the AACE/ACA task force explains, evidence suggests that both diabetes itself and obesity may increase the risk for certain cancers, and thus far there are no large-scale randomized studies to definitively link any medication with an increased cancer risk.
The 19-page document reviews the current evidence related to cancer and obesity, endogenous insulin, and diabetes itself, as well as to the various antihypertensive medications.
The authors note that the time lag between exposure to any carcinogen and cancer in humans can be as long as 20 to 50 years. “This is an essential point to consider when weighing the totality of evidence linking disease-state relationships with cancer or the role that pharmacotherapy may play in cancer development.”
Cancer screening and counseling on lifestyle changes should be a part of regular preventive care in people with obesity and/or diabetes, the group advises. Conversely, people who develop “typical” obesity-related cancers, especially at a younger age, should be screened for metabolic abnormalities.
When a physician prescribes antihyperglycemic medications, “a comprehensive risk/benefit analysis must be performed to include assessment of baseline personal and familial risk of malignancies in specific organ systems.”
On the flip side, there has also been emerging evidence that metformin and possibly the thiazolidinediones (TZDs) could be associated with a lower risk for cancer, the task force says. “Nonetheless, it is premature to prescribe metformin and TZDs solely for these as-yet-unproven indications.”
via Blogger http://chiropractic-lane.blogspot.com/2013/08/cancer-risk-from-diabetes-drugs-unproven.html
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