Epidemiological studies have shown patients with insulin resistance or have been diagnosed with type 2 diabetes mellitus associated with risk of epithelial malignancy among postmenopausal breast cancer, prostate, colon and kidney, although several other researchers who did not approve it.
Other studies also showed that high fasting insulin levels in women increases the risk of breast cancer, more breast cancer patients also suffer from diabetes mellitus and found a higher mortality than non-diabetic patients with breast cancer, therefore, appears to improve insulin resistance and hyperinsulinemia may be an effective strategy to reduce the risk of developing breast cancer and reduce the risk of breast cancer mortality in patients with diabetes.
The foundation of thinking is characteristic of type 2 diabetes have insulin resistance and hyperinsulinemia, and insulin has metabolic effects, including mitogenic effects mediated by the IGF receptor (insulin-like growth factor) -1 and insulin receptor, whereas metformin works by improving hyperinsulinemia and insulin resistance mainly by decreasing the gluconeogenesis hearts and increase blood glucose uptake into muscle, in vitro studies show breast cancer cells metformin not only works as “insulin-sensitizing drug” but capable of as a barrier to growth, upregulasi activity mediated by AMP activated protein kinase (AMPK) and suppress the flow signal on mTOR (mammalian Target of Rapamycin) with the results of this work suggested that metformin would directly as an anti-tumor by activating AMPK and the consequences will eventually interfere with the metabolism of cancer cells.
Based on the above items and the high incidence of breast cancer and there are allegations of metformin will affect the development and growth of breast cancer, researchers in the UK by using data from the General Practice Research Database (GPRD) conducted a case control analysis to investigate the relationship between long-term use of metformin and other hypoglycemic drugs against the risk of developing breast cancer.
The study involved 22,621 female patients who received at least one prescription Oho (oral hypoglycaemic agents) in 1 study, in this study identified 305 patients diagnosed with breast cancer who fulfilled the inclusion criteria with an average age of 67.5 years at the time of cancer diagnosis, with the control group (matched) is the 1153 women free of cancer. Where the proportion of age, BMI, smoking status, hormone use, history of diabetes, HbA1c levels and the percentage of cardiac and liver function in both groups comparable.
From the results of correlation of breast cancer in patients with diabetes who received insulin therapy Oho and odds ratio (see the effects / events to demonstrate the strength of the relationship, where the OR is less than 1 indicates less conditions or events occur in the first group STB) in the non-metformin group was 1.03 (95% CI, 0.76 to 1.39) in the delivery of insulin, sulfonylurea, thiazolidinediones, whereas the stratification on the use of metformin with duration of use of more than 40 times the prescription (5 years) lower risk of breast cancer with OR 0 , 44 (95% CI 0.24 to 0.82, p = 0.01).
In a further analysis to assess the OR in patients receiving anti-diabetic drug metformin with exclusion group that also received insulin in prescribing over 40, between metformin and non-metformin group obtained metformin group OR 0.42 (95% CI 0.21 to 0, 87, p = 0.02), whereas the non-metformin group no changes.
The result of these observations reinforce the scientific evidence metformin long period seems related to lower breast cancer risk, although still limited by the design of this study are only a observation study so that direct links are inconclusive.
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