Insulin therapy in diabetes and cancer risk: Current understanding and implications for future study

Stephen CL Gough, Cristobal Belda-Iniesta, Christopher Poole, Matthias Weber, David Russell-Jones, Bo Falck Hansen, Edoardo Mannucci, Jaakko Tuomilehto

Research output: Contribution to journalConference articleScientificpeer-review

Abstract

INTRODUCTION: Interest in the possibility of certain insulin treatments having the potential to modify cancer development and prognosis was reawakened in 2009, following publication of several epidemiological studies addressing this issue. This interest extends to how diabetes itself and cancer might be linked, and makes desirable an exchange of expert views and knowledge to enhance understanding in this subject among those treating diabetes and cancer, or those developing diabetes therapies.

METHODS: A European meeting was convened with participants invited based on known relevant interests in endocrinology, oncology, epidemiology, and insulin analog design and investigation. Experts in these fields were invited to present on relevant topics, with open discussions held after each presentation.

RESULTS: Concern over the potential mitogenic properties of certain insulin analogs has arisen from some (but not all) epidemiological studies, although confounding factors render interpretation controversial. Future epidemiological studies are likely to strengthen confidence in drawing conclusions. Meanwhile, pharmacological studies, and a consideration of cancer pathophysiology, implicate increased insulin-like growth factor-1 receptor affinity, and/or deranged insulin receptor interaction/signaling properties as possible a priori causes for concern with some insulin analogs. Again, interpretation of the body of pharmacological evidence is confounded by the array of test systems and methodologies used, and by studies frequently succumbing to methodological pitfalls. Reassuringly, most available insulin analogs do not differ in their receptor interaction response profile to human insulin, and for those that do there are reasons to question any potential clinical relevance. Nevertheless, it is desirable that new experimental models are devised that can better determine the likely clinical consequences of any variance in receptor response profile versus human insulin.

CONCLUSION: More data are required to increase our understanding of this issue. To facilitate and disseminate such understanding, close cooperation and communication between diabetologists, epidemiologists, oncologists, and insulin engineers will be essential.

Original languageEnglish
JournalAdvances in Therapy
Volume28
Issue numbersuppl 5
Pages (from-to)1-18
Number of pages18
ISSN0741-238X
DOIs
Publication statusPublished - 2011
MoE publication typeA4 Article in conference proceedings
EventA Meeting of a European Insulin Safety Consensus Panel - Middlesex, United Kingdom
Duration: 5 Oct 2010 → …

Fields of Science

  • 3142 Public health care science, environmental and occupational health
  • cancer
  • diabetes
  • detemir
  • glargine
  • insulin
  • insulin-like growth factor
  • insulin receptor
  • mitogenicity

Cite this

Gough, S. CL., Belda-Iniesta, C., Poole, C., Weber, M., Russell-Jones, D., Hansen, B. F., ... Tuomilehto, J. (2011). Insulin therapy in diabetes and cancer risk: Current understanding and implications for future study. Advances in Therapy, 28(suppl 5), 1-18. https://doi.org/10.1007/s12325-011-0047-8
Gough, Stephen CL ; Belda-Iniesta, Cristobal ; Poole, Christopher ; Weber, Matthias ; Russell-Jones, David ; Hansen, Bo Falck ; Mannucci, Edoardo ; Tuomilehto, Jaakko. / Insulin therapy in diabetes and cancer risk : Current understanding and implications for future study. In: Advances in Therapy. 2011 ; Vol. 28, No. suppl 5. pp. 1-18.
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title = "Insulin therapy in diabetes and cancer risk: Current understanding and implications for future study",
abstract = "INTRODUCTION: Interest in the possibility of certain insulin treatments having the potential to modify cancer development and prognosis was reawakened in 2009, following publication of several epidemiological studies addressing this issue. This interest extends to how diabetes itself and cancer might be linked, and makes desirable an exchange of expert views and knowledge to enhance understanding in this subject among those treating diabetes and cancer, or those developing diabetes therapies. METHODS: A European meeting was convened with participants invited based on known relevant interests in endocrinology, oncology, epidemiology, and insulin analog design and investigation. Experts in these fields were invited to present on relevant topics, with open discussions held after each presentation. RESULTS: Concern over the potential mitogenic properties of certain insulin analogs has arisen from some (but not all) epidemiological studies, although confounding factors render interpretation controversial. Future epidemiological studies are likely to strengthen confidence in drawing conclusions. Meanwhile, pharmacological studies, and a consideration of cancer pathophysiology, implicate increased insulin-like growth factor-1 receptor affinity, and/or deranged insulin receptor interaction/signaling properties as possible a priori causes for concern with some insulin analogs. Again, interpretation of the body of pharmacological evidence is confounded by the array of test systems and methodologies used, and by studies frequently succumbing to methodological pitfalls. Reassuringly, most available insulin analogs do not differ in their receptor interaction response profile to human insulin, and for those that do there are reasons to question any potential clinical relevance. Nevertheless, it is desirable that new experimental models are devised that can better determine the likely clinical consequences of any variance in receptor response profile versus human insulin. CONCLUSION: More data are required to increase our understanding of this issue. To facilitate and disseminate such understanding, close cooperation and communication between diabetologists, epidemiologists, oncologists, and insulin engineers will be essential.",
keywords = "3142 Public health care science, environmental and occupational health, cancer , diabetes, detemir, glargine, insulin, insulin-like growth factor, insulin receptor, mitogenicity",
author = "Gough, {Stephen CL} and Cristobal Belda-Iniesta and Christopher Poole and Matthias Weber and David Russell-Jones and Hansen, {Bo Falck} and Edoardo Mannucci and Jaakko Tuomilehto",
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Gough, SCL, Belda-Iniesta, C, Poole, C, Weber, M, Russell-Jones, D, Hansen, BF, Mannucci, E & Tuomilehto, J 2011, 'Insulin therapy in diabetes and cancer risk: Current understanding and implications for future study' Advances in Therapy, vol. 28, no. suppl 5, pp. 1-18. https://doi.org/10.1007/s12325-011-0047-8

Insulin therapy in diabetes and cancer risk : Current understanding and implications for future study. / Gough, Stephen CL; Belda-Iniesta, Cristobal; Poole, Christopher; Weber, Matthias; Russell-Jones, David; Hansen, Bo Falck; Mannucci, Edoardo; Tuomilehto, Jaakko.

In: Advances in Therapy, Vol. 28, No. suppl 5, 2011, p. 1-18.

Research output: Contribution to journalConference articleScientificpeer-review

TY - JOUR

T1 - Insulin therapy in diabetes and cancer risk

T2 - Current understanding and implications for future study

AU - Gough, Stephen CL

AU - Belda-Iniesta, Cristobal

AU - Poole, Christopher

AU - Weber, Matthias

AU - Russell-Jones, David

AU - Hansen, Bo Falck

AU - Mannucci, Edoardo

AU - Tuomilehto, Jaakko

N1 - Volume: 28 Host publication title: Proceedings from a Meeting of a European Insulin Safety Consensus Panel Proceeding volume:

PY - 2011

Y1 - 2011

N2 - INTRODUCTION: Interest in the possibility of certain insulin treatments having the potential to modify cancer development and prognosis was reawakened in 2009, following publication of several epidemiological studies addressing this issue. This interest extends to how diabetes itself and cancer might be linked, and makes desirable an exchange of expert views and knowledge to enhance understanding in this subject among those treating diabetes and cancer, or those developing diabetes therapies. METHODS: A European meeting was convened with participants invited based on known relevant interests in endocrinology, oncology, epidemiology, and insulin analog design and investigation. Experts in these fields were invited to present on relevant topics, with open discussions held after each presentation. RESULTS: Concern over the potential mitogenic properties of certain insulin analogs has arisen from some (but not all) epidemiological studies, although confounding factors render interpretation controversial. Future epidemiological studies are likely to strengthen confidence in drawing conclusions. Meanwhile, pharmacological studies, and a consideration of cancer pathophysiology, implicate increased insulin-like growth factor-1 receptor affinity, and/or deranged insulin receptor interaction/signaling properties as possible a priori causes for concern with some insulin analogs. Again, interpretation of the body of pharmacological evidence is confounded by the array of test systems and methodologies used, and by studies frequently succumbing to methodological pitfalls. Reassuringly, most available insulin analogs do not differ in their receptor interaction response profile to human insulin, and for those that do there are reasons to question any potential clinical relevance. Nevertheless, it is desirable that new experimental models are devised that can better determine the likely clinical consequences of any variance in receptor response profile versus human insulin. CONCLUSION: More data are required to increase our understanding of this issue. To facilitate and disseminate such understanding, close cooperation and communication between diabetologists, epidemiologists, oncologists, and insulin engineers will be essential.

AB - INTRODUCTION: Interest in the possibility of certain insulin treatments having the potential to modify cancer development and prognosis was reawakened in 2009, following publication of several epidemiological studies addressing this issue. This interest extends to how diabetes itself and cancer might be linked, and makes desirable an exchange of expert views and knowledge to enhance understanding in this subject among those treating diabetes and cancer, or those developing diabetes therapies. METHODS: A European meeting was convened with participants invited based on known relevant interests in endocrinology, oncology, epidemiology, and insulin analog design and investigation. Experts in these fields were invited to present on relevant topics, with open discussions held after each presentation. RESULTS: Concern over the potential mitogenic properties of certain insulin analogs has arisen from some (but not all) epidemiological studies, although confounding factors render interpretation controversial. Future epidemiological studies are likely to strengthen confidence in drawing conclusions. Meanwhile, pharmacological studies, and a consideration of cancer pathophysiology, implicate increased insulin-like growth factor-1 receptor affinity, and/or deranged insulin receptor interaction/signaling properties as possible a priori causes for concern with some insulin analogs. Again, interpretation of the body of pharmacological evidence is confounded by the array of test systems and methodologies used, and by studies frequently succumbing to methodological pitfalls. Reassuringly, most available insulin analogs do not differ in their receptor interaction response profile to human insulin, and for those that do there are reasons to question any potential clinical relevance. Nevertheless, it is desirable that new experimental models are devised that can better determine the likely clinical consequences of any variance in receptor response profile versus human insulin. CONCLUSION: More data are required to increase our understanding of this issue. To facilitate and disseminate such understanding, close cooperation and communication between diabetologists, epidemiologists, oncologists, and insulin engineers will be essential.

KW - 3142 Public health care science, environmental and occupational health

KW - cancer

KW - diabetes

KW - detemir

KW - glargine

KW - insulin

KW - insulin-like growth factor

KW - insulin receptor

KW - mitogenicity

U2 - 10.1007/s12325-011-0047-8

DO - 10.1007/s12325-011-0047-8

M3 - Conference article

VL - 28

SP - 1

EP - 18

JO - Advances in Therapy

JF - Advances in Therapy

SN - 0741-238X

IS - suppl 5

ER -

Gough SCL, Belda-Iniesta C, Poole C, Weber M, Russell-Jones D, Hansen BF et al. Insulin therapy in diabetes and cancer risk: Current understanding and implications for future study. Advances in Therapy. 2011;28(suppl 5):1-18. https://doi.org/10.1007/s12325-011-0047-8