Diabetic complication severity index directly associated with Cancer risk, claims research

Diabetes is a global pandemic, causing potential healthcare and economic burdens. It can cause multiple complications like vascular and nonvascular issues. Apart from the healthcare burdens, it also causes an increased risk of cancers. Research shows that the accumulation of advanced glycation end products is leading to the development of diabetic complications and also cancer. As there is ambiguity on the association between diabetic complications and cancer risk, researchers from Taiwan have conducted a study to assess the association between the degree of disease severity and the risk of cancer in patients with diabetes.

A 13-year retrospective cohort study was conducted using the National Health Insurance Research Database from 2000 through 2013. The study also included newly diagnosed diabetics. All the vascular and metabolic complications were collected to develop an adapted diabetic complication severity index (aDCSI) that ranges from 0-13. The aDCSI includes seven categories of complications: cardiovascular disease, stroke, peripheral vascular disease, retinopathy, nephropathy, neuropathy, and metabolism, with a total score of 0–13. All the individuals were followed up from the diabetes onset to the detection of cancer or death. Cancer diagnosis due to any reason was the outcome of interest.

Findings:

• Within the mean follow-up period of 9 years, the rates of cancer incidence per 100,000 person-years were 482.0, 585.4, 662.1, 724.4, 748.5, and 815.2 among men with aDCSI scores of 0, 1, 2, 3, 4 and 5+, respectively.
• Similarly, the cancer rates in women were 358.9, 436.4, 501.3, 515.6, 544.2, and 611.1 with aDCSI scores of 0, 1, 2, 3, 4, and 5+, respectively.
• The risk of cancer was 1.7- to 1.9-fold for the top vs bottom quartiles of aDCSI in diabetic onset age of 40–44.
• However, among patients with diabetic onset age of 60–64, the associations between the severity of diabetic complications and cancer risk were attenuated in women.
• There is an 8–17% and 7–20% increase in the risk of cancers with higher aDCSI in males and females, respectively.

Thus, the study is the first of its kind to establish an association between the severity of diabetic complications and the risk of cancer. This can help evaluate the cancer risk using glucose levels that vary considerably in individuals based on cancer outcomes. The researchers also encourage enhanced cancer screening protocols targeting the high-risk group of individuals. They also suggest using the adapted diabetic complication severity index (aDCSI) as a tool for early detection.

Further reading:

Tseng YH, Tsan YT, Chen PC. Association between severity of diabetic complications and risk of cancer in middle-aged patients with type 2 diabetes. J Diabetes Investig. Published online November 22, 2024. doi:10.1111/jdi.14364.