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KOK Edit: your favorite copyeditor since 1984(SM) KOK Edit: your favorite copyeditor since 1984(SM) Katharine O'Moore Klopf
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Saturday, June 27, 2009

Lantus Insulin May Be Linked to Cancer

Just heard about this on Twitter, and it worries me, because I take Lantus (generic name: glargine) insulin as one of the medications for my newly diagnosed type 2 diabetes:

"Studies Show Diabetes Drug Might Have Cancer Link," says the headline of a story in the Wall Street Journal; the drug in question is Lantus. I couldn't read the full story because it's behind a subscription firewall; if you have a subscription, you should be able to read it. I found a version from the news service Reuters:
Sanofi-Aventis (SASY.PA) said on Friday that new data on the safety of its blockbuster diabetes drug Lantus had not reached any definitive conclusions on a possible link to cancer.

The French drugmaker has been rocked in the past two days by a safety scare over Lantus, following rumours that a damaging analysis of the product's safety was shortly to be published in a major medical journal. Its stock fell 8 percent on Friday.

Sanofi said it had just been made aware of data associated with a retrospective follow-up of four patient registries but said no firm conclusions could be drawn on any possible causal link to the occurrence of malignancies.

It added that the authors of the study had also pointed this out.

"We consider that the results of these patient registries are not conclusive," Jean-Pierre Lehner, the company's chief medical officer, said in a statement. ...
And here's a story from Science Daily with more info on the science:
The risk of cancer possibly increases if patients with diabetes use the long-acting insulin analogue glargine instead of human insulin. The Institute for Quality and Efficiency in Health Care (IQWiG), in collaboration with the "Wissenschaftliches Institut der AOK" (WIdO), the research institute of the German Local Health Care Fund, analysed the data of almost 130,000 patients with diabetes in Germany who had been treated with either human insulin or the insulin analogues lispro (trade name: Humalog), aspart (Novorapid) or glargine (Lantus) between January 2001 and June 2005.

The analysis has now been published together with further studies in the scientific journal Diabetologia.

The disturbing result is that malignancies were found more frequently in patients treated with glargine than in those prescribed a comparable dose of human insulin. "Our analysis does not provide absolute proof that glargine promotes cancer," says Peter T. Sawicki, IQWiG's Director and co-author of the study. "Our study does, however, arouse an urgent suspicion which should have consequences for the treatment of patients." ...
Ironically, when I viewed the page, there was a Lantus banner ad at the top.

Here are PDFs of the uncorrected author page proofs of soon-to-be-in-print studies that initially raised alarms, made freely available by the medical journal Diabetologia because lots of people are concerned about Lantus now:

Two of the studies found a possible risk; the other two had inconclusive results.

If you take Lantus, please have a chat with your physician—as I plan to do with mine as soon as I can get an appointment—about the advisability of switching to another kind of injectable insulin. Do not stop taking Lantus without consulting your physician. Yes, I know, lots of substances are carcinogenic, but if you can avoid injecting a potential carcinogen into your body, that's probably a good thing.

By the way, because Sarnoff-Aventis is the maker of Lantus, its stocks' values are dropping because of the news.


Updated at 12:03 a.m., June 28, 2009: The Reuters story has been updated.


Updated at 11:13 p.m., June 28, 2009: Here is a very balanced discussion of the issues from a diabetes expert who has type 2 diabetes herself.


Updated at 8:45 a.m., June 29, 2009: Here is a Q&A from Reuters.


Updated at 5:11 p.m., June 29, 2009: And now, Sanofi weighs in, trying to make the Lantus studies out to be much ado about nothing.


19 comments:

Kaye said...

This is so scary for me as a Mom to a 16 year old Type 1 Diabetic. I hope we find out more soon...Thanks

Caryn Sobel said...

Katharine,

I am so glad you are in a position to find these things out early. I will keep my ears open for you, too, and see if I hear anything anecdotal at work from the docs. You just keep doing what you've been doing, and getting healthier every day.

Katharine O'Moore-Klopf said...

Kaye, I'd be interested in hearing from you again once you and your teen have had a chance to talk with your teen's physician.

Caryn, thank you, as always, for caring. And yes, I'm doing my best to continue eating well.

Anonymous said...

Kaye, I also have a type 1 teenager and will be calling his endocrinologist on Monday to find out about switching to the human insulin. I wish I had known there was an alternative! Very upsetting, please let us know how you make out as well.

Anonymous said...

Our 17 year old son took lantus for many years. He was diagnosed with leukemia at the age of 10. Thank god for the folks at Loma Linda childrens hospital he has now been cancer free for 5years, but this makes us wonder if it had anything to do with the cancer as they never could tell us why he got it.

Since he started to use his OmniPod insulin pump he only uses humalog now. But we still wonder....

Anonymous said...

If you read those articles, you will see that Lantus actually had a LOWER incidince of cancer risk than human insulin, but then the authors adjusted the dose upward of the Lantus because the human insulin doses were so much higher. So in actuality, pts on Lantus in this review had a lower incidence of cancer on the doses that they were put on by their doctor, which were probably achieving the desired results. The question is: Real world usage vs mathematical monkey business. I for one will stay on my Lantus, because the quality of my life on NPH is miserable. Hypoglycemia, weight gain, waking up in the middle of the night to use the bathroom, its just not worth it. I will take my chances on my 'real world' dose.

Anonymous said...

To anonymous poster at 12:46. Lantus has only been on the market since 2001, so he couldn't have gotten cancer from 'taking Lantus for many years' if he was diagnosed at age 10 (seven years ago).

Anonymous said...

I'm a type 1 diabetic. I've been on Lantus for about 5 years. This past January I was diagnosed with colon cancer with no family history. Makes me wonder...

Anonymous said...

You can look into another Insulin Analog, Levemir. It has a better safety profile compared to Lantus and human insulin and there are no links to cancer.

Mary Beth said...

oh wow. My dad has Type II and has just added Lantus to his other insulin. Thanks for this heads up!

Jim, Guacamole Diet said...

If you have "newly diagnosed type 2 diabetes," do you really need insulin already?

Did you try pills? Or better yet, did you try a rigorous low-carb diet?

Just asking.

Everybody has to figure out what works for them, but a very strict diet is doing wonders for my Type 2 diabetes, even though all my doctors and my endocrinologist had said it wasn't possible without drugs.

The doctors were wrong.

Best wishes.

Katharine O'Moore-Klopf said...

Jim, thanks for your concern, but everyone is physiologically different.

At my diagnosis, my fasting blood glucose level was sky high; if I hadn't begun taking medication right away, I would have had to have been hospitalized. And yet a year earlier, my A1C reading was considered prediabetic. My father had type 1 diabetes, my mother had type 2, and I had gestational diabetes during my last pregnancy 7 years ago. Having gestational diabetes increases by more than 50% a woman's likelihood of developing type 2 diabetes within the following 10 years.

I am taking metformin and Lantus. I am rigorously controlling my food intake and types of foods on the advice of a dietitian and research. It's likely that I'll eventually be able to stop taking Lantus.

Kaye said...

I've just talked to my doctor about my 16 year old Type 1 Diabetic taking the Lantus. He has changed him to Anolog Levemir. It comes in a Flixpen which is good for my teenager. I'll let you know more after he has been on it for a while. Going to pick it up today.

Katharine O'Moore-Klopf said...

Thanks very much for the update, Kaye. I'll be thinking of your teen.

C. J. said...

Thanks for all the information! I am a type-1 diabetic. I was diagnosed a little over three years ago (at the age of 20), and have been on Lantus for the whole time (of course). While I won't lose sleep over this for now, it is imperative to check with your endocrinologist.

I will definitely continue researching and talking with my doctors! :)

K said...

Hey...Kaye here again. My son, Matt..16, has been on the new med, Levemir, for a couple of weeks now. This is a 6' 200 lb boy and he was taking 50 units of Lantus before. Now he's taking 40 of Levemir every night. He started out taking the same amount but woke up low every morning...in the 40-60's. He started the lower dose of Levemir and he's waking up at 90 now. Just wanting to post...so far so good...Kaye

Katharine O'Moore-Klopf said...

Hi, Kaye. Hurray for Matt! I'm glad he and his physician have found an insulin and a dosage that works well for him. Hope you're feeling good, dude. (Sorry; my 14-year-old son thinks I'm dorky. It's a mom thing.) :-)

Kaye said...

Well, its been three months now for my son, Matt, being on the new Levemir. He's leveled out at taking 38 every night. Glad he doesn't have to take as much as he was with Lantus. His A1C is coming up in another couple of weeks. Hope he's doing better. It was a high 9.5 last time. Let you know....Kaye

Anonymous said...

I have been a type 1 dybetic for over 30 years. I was put on lantus insulin but had side effects as a result one of which was emptying bowel at least 10 times a day. this and reading reports about lantus possible link to cancer made me ask my consultant to change to levemir. I must admit i had a better control with lantus my blood glucose reading was always 6 mmo/d. whreras now with levemere my blood sugar is all over the place. I want to go back to lantus but reading these studies made me really scare. Hashim

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