The world is now facing the epidemic of over weight, obesity and diabetes, which in turn also increase the incidences of cancer. Insulin originally discovered in 1921 is still the gold standard for the management of diabetes. Treatment of diabetes with insulin and intensive therapies decreases blood glucose levels and undoubtedly prevents microvascular complications; however, the occurrence and prevention of cancer still require solid supporting data. Early this month we have been going through confusing stories on insulin glargine probably having an influence on occurrence of neoplasm.

          An editorial and articles published in Diabetologia (June 2009), the EASD journal, studied 3,40,935 diabetics in Sweden, Germany, Scotland and U.K. German study found that there is a decrease in both cancer risk and all-cause mortality when insulin glargine is compared to human insulin; the Swedish study found no increase in overall cancer risk with insulin glargine, but for breast cancer an increased risk with use of insulin glargine alone, but not in combination with other insulin, and with a decrease in all-cause mortality; The Scottish study found no increase in overall cancer risk with insulin glargine and uninterpretable data with regard to breast cancer. The UK THIN study found no increase in overall cancer risk and no increase in breast cancer risk with insulin glargine but they found that metformin mono-therapy carried the lowest risk of cancer, whereas in comparison to metformin, there was an increased cancer risk either with insulin secretagogues or with insulin.

          Almost all treatments have some disadvantages. Yet, disadvantages must always be balanced with advantages. Our view is that insulin glargine should continue to be used, and certainly should not be discontinued on the basis of unproven reports from a section of scientific community. Findings from these research papers (Diabetologia) are conflicting and inconclusive, and the American Diabetes Association issued a statement which cautions against over-reaction until more information is available.

          Please go through the following links - one an editorial by Satish K. Garg, M.D, Irl B. Hirsch, M.D. and Jay S. Skyler, M.D.in Diabetes Technology and Therapeutic Journal published online and the other is JDC position statement.

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JDC Position Statement on glargine:
http://www.jothydev.net/prgms/2009/lantus_2009.html