Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/7508
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: New Users of Metformin Are at Low Risk of Incident Cancer A cohort study among people with type 2 diabetes
Authors: Libby, Gillian
Donnelly, Louise A
Donnan, Peter T
Alessi, Dario R
Morris, Andrew D
Evans, Josie
Contact Email: josie.evans@stir.ac.uk
Issue Date: Sep-2009
Publisher: American Diabetes Association
Citation: Libby G, Donnelly LA, Donnan PT, Alessi DR, Morris AD & Evans J (2009) New Users of Metformin Are at Low Risk of Incident Cancer A cohort study among people with type 2 diabetes, Diabetes Care, 32 (9), pp. 1620-1625.
Abstract: OBJECTIVE: The antidiabetic properties of metformin are mediated through its ability to activate the AMP-activated protein kinase (AMPK). Activation of AMPK can suppress tumor formation and inhibit cell growth in addition to lowering blood glucose levels. We tested the hypothesis that metformin reduces the risk of cancer in people with type 2 diabetes. RESEARCH DESIGN AND METHODS: In an observational cohort study using record-linkage databases and based in Tayside, Scotland, U.K., we identified people with type 2 diabetes who were new users of metformin in 1994-2003. We also identified a set of diabetic comparators, individually matched to the metformin users by year of diabetes diagnosis, who had never used metformin. In a survival analysis we calculated hazard ratios for diagnosis of cancer, adjusted for baseline characteristics of the two groups using Cox regression. RESULTS: Cancer was diagnosed among 7.3% of 4,085 metformin users compared with 11.6% of 4,085 comparators, with median times to cancer of 3.5 and 2.6 years, respectively (P less than 0.001). The unadjusted hazard ratio (95% CI) for cancer was 0.46 (0.40-0.53). After adjusting for sex, age, BMI, A1C, deprivation, smoking, and other drug use, there was still a significantly reduced risk of cancer associated with metformin: 0.63 (0.53-0.75). CONCLUSIONS: These results suggest that metformin use may be associated with a reduced risk of cancer. A randomized trial is needed to assess whether metformin is protective in a population at high risk for cancer.
Type: Journal Article
URI: http://hdl.handle.net/1893/7508
DOI Link: http://dx.doi.org/10.2337/dc08-2175
Rights: Publisher policy allows this work to be made available in this repository. Published in Diabetes Care by American Diabetes Association. The original publication is available at: http://care.diabetesjournals.org/content/32/9/1620
Affiliation: University of Dundee
University of Dundee
University of Dundee
University of Dundee
University of Dundee
HS Research - Stirling

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