Type 2 diabetes mellitus and survival in pancreatic adenocarcinoma: a retrospective cohort study.

Abstract:

BACKGROUND:Recent evidence has identified pre-existing type 2 diabetes mellitus (T2DM) as a risk factor for the development of PAC, but relatively little is known about its effects on survival. Our aim was to determine the effect of varying durations of pre-existing T2DM on survival in patients with PAC. METHODS:We conducted a retrospective cohort study using The Health Improvement Network (THIN), a primary care electronic medical record database from the UK (2003-2010). The study cohort included all subjects with a diagnostic code for PAC. Subjects with a diagnostic code for T2DM before their PAC diagnosis were classified as exposed; otherwise, subjects were classified as unexposed. The primary outcome was overall survival. The analysis was performed using univariate and multivariable Cox proportional-hazards models. Additional analysis was performed to assess the effect of increasing duration of pre-existing T2DM [i.e., <90 days, 90 days to <1 year, 1 to <3 years, 3 to 5 years, >5 years] on survival. RESULTS:The study included 3,147 patients with PAC, with 745 patients having pre-existing T2DM and 2,402 patients without pre-existing T2DM. In the primary multivariate analysis, there was no difference in survival between those exposed and those unexposed to pre-existing T2DM (HR 1.02 [0.93, 1.12], p = 0.620). In the secondary analysis, only those patients with T2DM > 5 years duration had a significantly increased mortality (HR 1.16 [1.00, 1.33], p < 0.05). CONCLUSIONS:Long-term pre-existing T2DM is associated with increased mortality in patients diagnosed with PAC.

journal_name

Cancer

journal_title

Cancer

authors

Hwang A,Narayan V,Yang YX

doi

10.1002/cncr.27731

subject

Has Abstract

pub_date

2013-01-15 00:00:00

pages

404-10

issue

2

eissn

0008-543X

issn

1097-0142

journal_volume

119

pub_type

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