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Debate at RSSDI Cochin, 2010 on " Insulin should be the first drug in type 2 diabetes" . I spoke against the motion.

Debate at RSSDI Cochin, 2010 on " Insulin should be the first drug in type 2 diabetes" . I spoke against the motion.

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  • Rate of progression of solid tumour cancers in people with diabetes receiving alternative glucose-lowering therapies (metformin monotherapy, black lines; sulfonylurea monotherapy, green lines; sulfonylurea plus metformin, blue lines; insulin-based therapy, red lines) and a group with no diabetes treatment exposure (grey lines). aUnadjusted (Kaplan–Meier curve). b Adjusted for confounding factors (age, sex, smoking status and prior cancer) using a Cox proportional hazards model
  • The risk of CRC was found to increase with duration of exposure to insulin use, the odds ratio increasing by 1.21 for each additional year of insulin use (95% CI, 1.03 - 1.42; P = .02). Those with fewer than three years of insulin therapy had an adjusted OR for CRC of 1.4 (95% CI, 0.6 - 2.9; P = 0.5), while those with three to five years of insulin exposure were at significantly higher risk (OR, 2.9; 95% CI, 1.1 - 7.7; P = .03). Those with more than five years of insulin use were at the greatest risk of developing CRC (OR, 4.7; 95% CI, 1.3 - 16.7; P = .02).