scholarly journals Is Colectomy Associated with the Risk of Type 2 Diabetes in Patients without Colorectal Cancer? A Population-Based Cohort Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5313
Author(s):  
Chin-Chia Wu ◽  
Cheng-Hung Lee ◽  
Ta-Wen Hsu ◽  
Chia-Chou Yeh ◽  
Mei-Chen Lin ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Proportional Hazards Model ◽  
Population Based ◽  
Cox Proportional Hazards Model ◽  
Colonic Disease ◽  
Research Database ◽  
Reduced Risk

Type 2 diabetes might be influenced by colonic disease; however, the association between colonic resection and type 2 diabetes has rarely been discussed. This population-based cohort study explored the association between colectomy and type 2 diabetes in patients without colorectal cancer. A total of 642 patients who underwent colectomy for noncancerous diseases at any time between 2000 and 2012 in the National Health Insurance Research Database of Taiwan were enrolled. The enrolled patients were matched with 2568 patients without colectomy at a 1:4 ratio using a propensity score that covered age, sex, and comorbidities. The risk of type 2 diabetes was assessed using a Cox proportional hazards model. The mean (standard deviation) follow-up durations in colectomy cases and non-colectomy controls were 4.9 (4.0) and 5.6 (3.6) years, respectively; 65 (10.1%) colectomy cases and 342 (15.5%) non-colectomy controls developed type 2 diabetes. After adjustment, colectomy cases still exhibited a decreased risk of type 2 diabetes (adjusted HR = 0.80, 95% CI: 0.61–1.04). A stratified analysis for colectomy type indicated that patients who underwent right or transverse colectomy had a significantly lower risk of developing type 2 diabetes (adjusted HR = 0.57, 95% CI: 0.34–0.98). In the present study, colectomy tended to be at a reduced risk of type 2 diabetes in patients without colorectal cancer, and right or transverse colectomies were especially associated with a significantly reduced risk of type 2 diabetes.

115 RISK OF POST-COLONOSCOPY COLORECTAL CANCER IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A DANISH POPULATION-BASED COHORT STUDY

2021 ◽  
Vol 160 (6) ◽  
pp. S-30
Author(s):  
Frederikke Sch⊘nfeldt Troelsen ◽  
Henrik Toft S⊘rensen ◽  
Lars Pedersen ◽  
Rune Erichsen
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Population Based ◽  
Danish Population

scholarly journals Insulin enhances and metformin reduces risk of colorectal carcinoma in type-2 diabetes

QJM ◽  
2019 ◽  
Author(s):  
C-H Chen ◽  
C-L Lin ◽  
C-Y Hsu ◽  
C-H Kao
Keyword(s):  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Dietary Habits ◽  
Occult Blood ◽  
Population Based ◽  
Study Cohort ◽  
Urbanization Level ◽  
Increased Risk

Abstract Background Identifying colorectal cancer associated risks is important for conducting a program for the survey and prevention of colorectal cancer. Aim To investigate the association between use of insulin or metformin with colorectal cancer (CRC) in type 2 diabetes (T2DM). Design Population-based cohort study. Methods Through analysis of National Health Insurance (NHI) database between 1998 and 2010 in Taiwan, we identified 66 324 T2DM patients aged ≥ 20 years and selected subjects without diabetes by 1: 1 randomly matching with the study cohort based on age, sex and index date. We followed up the participants until 31 December 2011 or when they withdrew from the NHI program. Results Compared with non-diabetic subjects, the T2DM patients exhibited an increased risk of CRC [adjusted HR (aHR) = 1.56, 95% confidence interval (CI) = 1.39–1.75], after adjustment for age, sex, urbanization level, comorbidities and examinations of colonoscopy, sigmoidoscopy, or stool occult blood test. Among the T2DM patients, insulin usage increased the risk of CRC (aHR = 1.86, 95% CI = 1.58–0–2.19) after adjustment for age, sex, urbanization level, comorbidities, metformin usage and examinations; nevertheless, metformin decreased the risk of CRC (aHR = 0.65, 95% CI = 0.54–0.77) after adjustment for age, sex, urbanization level, comorbidities, insulin usage and examinations. Compared with the non-insulin cohort, the risk of CRC tended to increase with the incremental dosage of insulin exposure. Conclusion Our population-based cohort study demonstrated an association between T2DM and CRC. Among the T2DM patients, insulin use was associated with an increased risk of CRC and metformin use was associated with a decreased risk of CRC. Inability to obtain information on several potential confounding factors, such as lifestyle and dietary habits, is the major limitation of the study.

scholarly journals Decreased risk of colorectal cancer among patients with type 2 diabetes receiving Chinese herbal medicine: a population-based cohort study

2020 ◽  
Vol 8 (1) ◽  
pp. e000732
Author(s):  
Jing-Siang Jhang ◽  
Hanoch Livneh ◽  
Shu-Yi Yang ◽  
Hui-Ju Huang ◽  
Michael W Y Chan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Proportional Hazards ◽  
Herbal Medicines ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Research Database ◽  
Chinese Herbal

ObjectivesPatients with type 2 diabetes have a higher risk of colorectal cancer (CRC), but whether Chinese herbal medicines (CHMs) can reduce this risk is unknown. This study investigated the effect that CHMs have on CRC risk in patients with type 2 diabetes.Research design and methodsThis cohort study used the Taiwanese National Health Insurance Research Database to identify 54 744 patients, newly diagnosed with type 2 diabetes, aged 20–70 years, who were receiving treatment between 1998 and 2007. From this sample, we randomly selected 14 940 CHMs users and 14 940 non-CHMs users, using propensity scores matching. All were followed through 2012 to record CRC incidence. Cox proportional hazards regression was used to compute the hazard ratio (HR) of CRC by CHMs use.ResultsDuring follow-up, 235 CHMs users and 375 non-CHMs users developed CRC, incidence rates of 1.73% and 2.47% per 1000 person-years, respectively. CHM users had a significantly reduced risk of CRC compared with non-CHM users (adjusted HR=0.71; 95% CI 0.60 to 0.84). The greatest effect was in those receiving CHMs for more than 1 year. Huang-Qin, Xue-Fu-Zhu-Yu-Tang, Shu-Jing-Huo-Xue-Tang, Liu-Wei-Di-Huang-Wan, Ji-Sheng-Shen-Qi-Wan, Gan-Lu-Yin, Shao-Yao-Gan-Cao-Tang and Ban-Xia-Xie-Xin-Tang were significantly associated with lower risk of CRC.ConclusionIntegrating CHMs into the clinical management of patients with type 2 diabetes may be beneficial in reducing the risk of CRC.

Clinically Confirmed Type 2 Diabetes Mellitus and Colorectal Cancer Risk: A Population-Based, Retrospective Cohort Study

2006 ◽  
Vol 101 (8) ◽  
pp. 1872-1879 ◽  
Author(s):  
Paul J. Limburg ◽  
Robert A. Vierkant ◽  
Zachary S. Fredericksen ◽  
Cynthia L. Leibson ◽  
Robert A. Rizza ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Cancer Risk ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based

scholarly journals Effect of Physical Activity and Obesity on Type 2 Diabetes in a Middle-Aged Population

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Rashid M. Ansari
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Stair Climbing ◽  
High Risk Population ◽  
Middle Aged ◽  
Aged Population ◽  
Reduced Risk

Background. The physical activity has been associated with a reduced risk of type 2 diabetes. The aim of this study was to examine the effect of physical activities such as occupational, household and daily lifestyle activities and obesity on the prevalence of type 2 diabetes in middle-aged population.Methods. All people (n= 2053), aged 45–64 years were selected for this study from the large sample of population-based cross-sectional data collected in the 1990–1994 by National Health Survey of Pakistan. The participants completed in-person interviews at baseline; the overall response rate was 92.6%. The Cox proportional hazards model was used to estimate the risk of developing the type 2 diabetes.Results. Stair climbing was found to be inversely associated with the risk of diabetes and cycling was also associated with a reduced risk of type 2 diabetes (; 95% CI 0.68–1.00, ). The relationship between physical activity and reduced risk of diabetes adjusted for age and body mass index was statistically significant only in women ().Conclusions. This study provides an incentive that physical activity in leisure-time exercise or daily activity reduces the risk of type 2 diabetes in a high-risk population.

scholarly journals Risk of a post-colonoscopy colorectal cancer in patients with type 2 diabetes: a Danish population-based cohort study

2021 ◽  
Vol 8 (1) ◽  
pp. e000786
Author(s):  
Frederikke Schønfeldt Troelsen ◽  
Henrik Toft Sørensen ◽  
Lars Pedersen ◽  
Rune Erichsen
Keyword(s):  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Increased Risk ◽  
First Time

ObjectivePrevalent type 2 diabetes (T2D) is associated with an increased risk of colorectal cancer and could impair the quality of bowel preparation for colonoscopy. This may in turn increase the risk of overlooked precancerous polyps and subsequent risk of post-colonoscopy colorectal cancer (PCCRC). We investigated whether patients with T2D are at increased risk of PCCRC compared with patients without T2D.DesignWe conducted a population-based cohort study of patients with T2D and without T2D undergoing colonoscopy in Denmark (1995–2015). We investigated the risk of PCCRC by calculating >6 to 36 months cumulative incidence proportions (CIPs) treating death and colectomy as competing risks. Using Cox proportional-hazards regression analyses, we also computed HRs of PCCRC, comparing patients with T2D and non-T2D. According to the World Endoscopy Organization guidelines, we calculated PCCRC 3-year rates to estimate the proportions of T2D and non-T2D CRC patients experiencing PCCRC.ResultsWe identified 29 031 patients with T2D and 333 232 patients without T2D undergoing colonoscopy. We observed 250 PCCRCs among patients with T2D and 1658 PCCRCs among patients without T2D. The >6 to 36 months CIP after a first-time colonoscopy was 0.64% (95% CI 0.55% to 0.74%) for T2D and 0.36% (95% CI 0.34% to 0.38%) for patients without T2D. The HRs of PCCRC were 1.43 (95% CI 1.21 to 1.72) after a first-time colonoscopy and 1.18 (95% CI 0.75 to 1.85) after a second-time colonoscopy. The PCCRC 3-year rate was 7.9% for patients with T2D and 7.4% for patients without T2D.ConclusionT2D may be associated with an increased HR of PCCRC.

scholarly journals Pay-for-performance programmes reduce stroke risks in patients with type 2 diabetes: a national cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e026626 ◽  
Author(s):  
Chien-Wen Chou ◽  
Pei-Tseng Kung ◽  
Wen-Yu Chou ◽  
Wen-Chen Tsai
Keyword(s):  
Type 2 Diabetes ◽  
Stroke Risk ◽  
Proportional Hazards Model ◽  
Pay For Performance ◽  
Haemorrhagic Stroke ◽  
Cox Proportional Hazards Model ◽  
Research Database ◽  
Related Factors ◽  
Significant Difference

ObjectivesA pay-for-performance (P4P) programme is a management strategy that encourages healthcare providers to deliver high quality of care. In Taiwan, the P4P programme has been implemented for diabetes, and certified diabetes physicians voluntarily enrol patients with diabetes into the P4P programme. The objectives of this study were to compare the risk of stroke and its related factors in patients with type 2 diabetes who were enrolled in a P4P programme compared with those who were not.Study designThis study is a natural experiment in Taiwan. A retrospective cohort investigation was conducted from 2002 to 2013, which included 459 726 patients with type 2 diabetes, who were grouped according to P4P enrolment status following a propensity score matching process.MethodsWe reviewed patients ≥45 years of age newly diagnosed with type 2 diabetes mellitus (DM) from the National Health Insurance Research Database in Taiwan. A Cox proportional hazards model was used to compare the relative risk of stroke between patients with type 2 DM enrolled in the P4P programme and those who were not enrolled.ResultsCompared with the patients not enrolled, there was a significantly lower stroke risk in P4P participants (HR=0.97, 95% CI 0.95 to 0.99). Although a significantly lower risk of haemorrhagic stroke was observed (HR=0.87, 95% CI 0.82 to 0.93) in P4P participants, no statistically significant difference for the risk of ischaemic stroke between P4P and non-P4P patients (HR=0.99, 95% CI 0.97 to 1.02) was found. Following stratification analysis, a significantly reduced stroke risk was observed in male patients with type 2 diabetes, but not in women.ConclusionsParticipants in Taiwan’s Diabetes P4P programme displayed a significantly reduced stroke risk, especially haemorrhagic stroke. We recommend the continual promotion of this programme to the general public and to physicians.

Sign in / Sign up

Export Citation Format

Share Document