Comment on: Yang et al. (2010) Associations of Hyperglycemia and Insulin Usage With the Risk of Cancer in Type 2 Diabetes: The Hong Kong Diabetes Registry. Diabetes;59:1254–1260

  1. Beverley Balkau3,4
  1. 1Service de Diabétologie, Hôpital de la Pitié, Paris, France;
  2. 2Université Pierre et Marie Curie, Paris, France;
  3. 3INSERM CESP Centre for Research in Epidemiology and Population Health, U 1018, Epidemiology of Diabetes, Obesity and Chronic Kidney Disease Over the Lifecourse, Villejuif, France;
  4. 4Université Paris 11, UMRS 1018, Villejuif, France.
  1. Corresponding author: Dominique Simon, dominique.simon{at}

Yang et al. (1) recently reported that insulin usage is associated with a reduced cancer risk. It contrasts with evidence from epidemiological surveys in healthy populations and from pharmaco-epidemiological studies in diabetic patients, suggesting that hyperinsulinemia and growth factors play a key role in the association—maybe causal relationship—between diabetes/hyperglycemia and cancer, as we reviewed recently (2). In the accompanying editorial (3), Johnson and Gale state “pearl of wisdom often taught in introductory epidemiology courses is that one should be wary of implausibly low (or high) …

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