The impact of type 2 DM in mortality of hospitalized female cancer patients in Taiwan

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 807-838-Diabetes - Diagnosis, Complications & Outcomes
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-826
Jen-Der Lin*1, Jeng-Yeou Chen2, Wen-Ko Chiou3 and Wei-Ying Chou3
1Chang Gung Memorial Hospital, Taoyuan, 2Chang Gung Memorial Hospital, 3Chang Gung University
Introduction:    Hyperinsulinemia is a characteristic of type 2 diabetes mellitus (DM). The growth-promoting mitogen of insulin binds to the insulin receptor, resulting in activation of insulin signaling cascades, and subsequently cell growth. The goal of this study was to determine the relationships between type 2 DM, specific cancer histologic types, and mortality in hospitalized women.

Methods:    In this retrospective study, the association between type 2 DM in Chinese female patients who were diagnosed with cancer and admitted to a hospital was determined. Women were identified through admission data from Chang Gung Memorial Hospital (CGMH) in Linkou, Taiwan between January 2000 and December 2010. The International Classification of Disease-9 (ICD-9) diagnostic codes was used to identify the disease states of patients and the presence of different cancer types in patients with and without type 2 DM was assessed. Patients over 19 years of age were included if the indication for hospital admission was a diagnosis of type 2 DM or a malignancy. A total of 67,660 females with a mean age 62.76 ± 14.48 years were enrolled. These patients were categorized into the following three groups: patients with cancer, but without DM (group A); patients with cancer and DM (group B); and patients with DM, but without cancer (group C). Attributable fractions (AFs) were calculated to evaluate the impact of type 2 DM for mortality in specific cancer. AFs were calculated as [(hazard ratio - 1)/ hazard ratio] X 100.

Results:      Of the study subjects, 37,204 (54.98 %) were diagnosed with type 2 DM. as follows: groups A, n=30,456; group B, n=5,992; and group C, n=31,212. Group B patients had a high frequency of pancreas, liver, and renal cancers, and a low frequency of thyroid, breast, and ovarian cancers. Of the 36,448 cancer patients, 2,906 (7.97%) died. The mortality rate of group B (10.45%) was significantly higher than groups A (7.48%; HR = 1.40) and C (3.44%; HR = 3.04). Type 2 DM increased mortality in most cancers. The data showed tope three AFs were thyroid cancer, NPC and urinary tract cancer.

Conclusion:      The findings of this study showed that the presence of type 2 DM may influence the development of certain cancer types. The mortality rates of female cancers with type 2 DM are more significantly increased in less aggressive cancer types.

Nothing to Disclose: JDL, JYC, WKC, WYC

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