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