Evidence map›Paper›PMID 26093337›Full record

ArticleNeuro-oncology2016

Diabetes, use of antidiabetic drugs, and the risk of glioma.

Corinna Seliger, Cristian Ricci, Christoph R Meier, Michael Bodmer, Susan S Jick, Ulrich Bogdahn, Peter Hau, Michael F Leitzmann

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PubMed Full text at PMC Publisher
In one paragraph

Article in Neuro-oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 5 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 5 syntheses or guidelines pooled it, 77 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 3 countries.

Corinna SeligerDepartment of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany (C.S., U.B., P.H.); Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (C.R., M.F.L.); Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland (C.R.M., M.B.); Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Boston University, Boston, Massachusetts, (C.R.M., S.S.J.); Hospital Pharmacy, University Hospital Basel, Basel, Switzerland (C.R.M.); Department of General Internal Medicine, University of Bern, Inselspital/Universitätsspital, Bern, Switzerland (M.B.).
Cristian RicciDepartment of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany (C.S., U.B., P.H.); Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (C.R., M.F.L.); Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland (C.R.M., M.B.); Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Boston University, Boston, Massachusetts, (C.R.M., S.S.J.); Hospital Pharmacy, University Hospital Basel, Basel, Switzerland (C.R.M.); Department of General Internal Medicine, University of Bern, Inselspital/Universitätsspital, Bern, Switzerland (M.B.).
Christoph R MeierDepartment of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany (C.S., U.B., P.H.); Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (C.R., M.F.L.); Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland (C.R.M., M.B.); Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Boston University, Boston, Massachusetts, (C.R.M., S.S.J.); Hospital Pharmacy, University Hospital Basel, Basel, Switzerland (C.R.M.); Department of General Internal Medicine, University of Bern, Inselspital/Universitätsspital, Bern, Switzerland (M.B.).
Michael BodmerDepartment of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany (C.S., U.B., P.H.); Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (C.R., M.F.L.); Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland (C.R.M., M.B.); Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Boston University, Boston, Massachusetts, (C.R.M., S.S.J.); Hospital Pharmacy, University Hospital Basel, Basel, Switzerland (C.R.M.); Department of General Internal Medicine, University of Bern, Inselspital/Universitätsspital, Bern, Switzerland (M.B.).
Susan S JickDepartment of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany (C.S., U.B., P.H.); Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (C.R., M.F.L.); Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland (C.R.M., M.B.); Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Boston University, Boston, Massachusetts, (C.R.M., S.S.J.); Hospital Pharmacy, University Hospital Basel, Basel, Switzerland (C.R.M.); Department of General Internal Medicine, University of Bern, Inselspital/Universitätsspital, Bern, Switzerland (M.B.).
Ulrich BogdahnDepartment of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany (C.S., U.B., P.H.); Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (C.R., M.F.L.); Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland (C.R.M., M.B.); Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Boston University, Boston, Massachusetts, (C.R.M., S.S.J.); Hospital Pharmacy, University Hospital Basel, Basel, Switzerland (C.R.M.); Department of General Internal Medicine, University of Bern, Inselspital/Universitätsspital, Bern, Switzerland (M.B.).
Peter HauDepartment of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany (C.S., U.B., P.H.); Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (C.R., M.F.L.); Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland (C.R.M., M.B.); Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Boston University, Boston, Massachusetts, (C.R.M., S.S.J.); Hospital Pharmacy, University Hospital Basel, Basel, Switzerland (C.R.M.); Department of General Internal Medicine, University of Bern, Inselspital/Universitätsspital, Bern, Switzerland (M.B.).
Michael F LeitzmannDepartment of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany (C.S., U.B., P.H.); Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (C.R., M.F.L.); Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland (C.R.M., M.B.); Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Boston University, Boston, Massachusetts, (C.R.M., S.S.J.); Hospital Pharmacy, University Hospital Basel, Basel, Switzerland (C.R.M.); Department of General Internal Medicine, University of Bern, Inselspital/Universitätsspital, Bern, Switzerland (M.B.).
Boston Collaborative Drug Surveillance Program · USBoston University · USUniversity Hospital of Basel · CHUniversity Hospital Regensburg · DEUniversity of Bern · CHUniversity of Regensburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrior epidemiologic studies suggest inverse relations between diabetes and glioma risk, but the underlying mechanisms, including use of antidiabetic drugs, are unknown.

methodsWe therefore performed a matched case-control analysis using the Clinical Practice Research Datalink (CPRD). We identified incident glioma cases diagnosed between 1995 and 2012 and matched each case with 10 controls on age, gender, calendar time, general practice, and years of active history in the CPRD. We performed conditional logistic regression to estimate odds ratios (ORs) with 95% CIs, adjusted for body mass index and smoking.

resultsWe identified 2005 cases and 20 050 controls. Diabetes was associated with decreased risk of glioma (OR = 0.74; 95% CI = 0.60-0.93), particularly glioblastoma (OR = 0.69; 95% CI = 0.51-0.94). Glioblastoma risk reduction was markedly pronounced among diabetic men (OR = 0.60; 95% CI = 0.40-0.90), most apparently for those with diabetes of long-term duration (OR for >5 vs 0 y = 0.46; 95% CI = 0.26-0.82) or poor glycemic control (OR for HbA1c ≥ 8 vs <6.5% = 0.20; 95% CI = 0.06-0.70). In contrast, the effect of diabetes on glioblastoma risk was absent among women (OR = 0.85; 95% CI = 0.53-1.36). No significant associations with glioma were found for use of metformin (OR for ≥ 30 vs 0 prescriptions = 0.72; 95% CI = 0.38-1.39), sulfonylureas (OR = 0.71; 95% CI = 0.39-1.30), or insulin (OR = 0.79; 95% CI = 0.37-1.69).

conclusionsAntidiabetic treatment appears to be unrelated to glioma, but long-term diabetes duration and increased HbA1c both show decreased glioma risk. Stronger findings in men than women suggest low androgen levels concurrent with diabetes as a biologic mechanism.

Indexed as

GliomaAdolescentAdultAgedAged, 80 and overBody Mass IndexChildChild, PreschoolDiabetes MellitusFemaleHumansHypoglycemic AgentsInfantLogistic ModelsMaleMiddle AgedHypoglycemic Agentsdiabetesepidemiologygliomametformintestosterone

Identifiers

PMID26093337
PMCPMC4767232
OpenAlexW1901450410

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.