Early glycaemic exposure and cancer risk in people with newly diagnosed type 2 diabetes
Main finding · Cancer at any site per 11 mmol/mol (1%) increase in time-weighted mean HbA1cResult — go to the resultHazard ratio 1.27 95% CI 1.20–1.33Authors' conclusion
Overall, hyperglycaemic exposure was associated with an elevated long-term cancer risk in type 2 diabetes. Notably, individuals who showed better glycaemic management soon after diagnosis exhibited a lower cancer risk than those whose glycaemic management improved later, despite comparable overall glycaemic burdens.
Study context
- Population
- Hong Kong Chinese people with newly diagnosed T2D49,978 analysed
- Participants
- 52,926 people
- Exposure
- Higher vs lower time-weighted mean HbA1c
- Outcome
- Incident cancer at any site
Methodological detailsterritory-wide, weighted cumulative exposure model
- Territory-wide
- Weighted cumulative exposure model
Main finding
As reported in the abstract
Hazard ratio
1.27
95% CI 1.20–1.33
Per 11 mmol/mol, as printed
- Cancer events
- 1758
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Cancer risk over hypothetical 10 year window per 11 mmol/mol (1%) HbA1c reduction at 1-2 yearsWeighted cumulative exposure model | 0.94 (0.91–0.98) | |
| 0.512Hazard ratio (log scale) |
Cancer at any site with time-weighted mean HbA1c ≥53 vs <53 mmol/mol in first 2 years after diagnosis
- 30-75% relative higher risk, depending on HbA1c category, even after adjusting for subsequent HbA1c
- Longer early exposure associated with higher risk, reaching 51-213% in the first 5 years of exposure
- Earlier high HbA1c exposures contributed more strongly to cancer risk than later exposures
Cancer risk over hypothetical 10 year window per 11 mmol/mol (1%) HbA1c reduction at 1-2 years
- Reductions after 5 years showed no significant risk differences
Original publication
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