Prevalence and Determinants of Diabetes Mellitus in 2338 Long-Term Dutch Childhood Cancer Survivors (DCCS-LATER2 Study)
Authors' conclusion
The identified 3-fold increased risk of DM in CCS, along with the clinically relevant and some modifiable determinants, underscores the importance of early risk-based screening and the exploration of lifestyle interventions in this population.
Study context
- Population
- Long-term Dutch childhood cancer survivors, nationwide cohort; median age 34.7 years, median follow-up 27.1 years
- Participants
- 2,338 vs 132,226
- Exposure
- Childhood cancer survivors vs Lifelines reference cohort
- Survivorsn = 2,338
- Referencen = 132,226reference
- Outcome
- DM: fasting glucose ≥7.0 mmol/L or nonfasting ≥11.1 mmol/L and/or self-report (previous diagnosis and/or medication use)
Methodological detailsnationwide, reference cohort (Lifelines), multivariable logistic regression adjusted for age, sex and body mass index (BMI)
- Nationwide
- Reference cohort (Lifelines)
- Multivariable logistic regression adjusted for age, sex and BMI
Main finding
As reported in the abstract
DM components, adjusted for age, sex and BMI
Each group vs referenceEstimate (95% CI)
Survivors
aOR, hyperglycemia 2.72(2.06–3.59)
Survivors
aOR, previous DM diagnosis 3.03(2.33–3.95)
Survivors
aOR, antidiabetic medication use 2.94(2.17–3.99)
Observational data: associations, not effects.
Further findings
Determinants of diabetes mellitus (DM) in childhood cancer survivors (CCS)
- Age >35 vs 18-35 years, OR
- 4.32 (1.84-10.15) (95% CI)
- BMI per point, OR
- 1.12 (1.08-1.16) (95% CI)
- Family history of DM, OR
- 2.38 (1.51-3.76) (95% CI)
- Prior abdominal/pelvic radiotherapy, OR
- 4.19 (2.32-7.55) (95% CI)
- Total body irradiation, OR
- 14.31 (6.98-29.34) (95% CI)
- Hypogonadism, OR
- 2.40 (1.15-4.99) (95% CI)
- Hypertension, OR
- 1.71 (1.06-2.76) (95% CI)
- Dyslipidemia, OR
- 3.81 (2.15-6.75) (95% CI)
- Statistically significant interaction between age and sex on DM development in survivors
- Multivariable logistic regression
Original publication
Prevalence and Determinants of Diabetes Mellitus in 2338 Long-Term Dutch Childhood Cancer Survivors (DCCS-LATER2 Study). J Clin Endocrinol Metab. Published 7 February 2025. doi:10.
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