Risk of Diabetes Associated With Cancer Development—In Reply

In Reply We agree with Hu et al that cancer and diabetes are closely associated with each other biologically and epidemiologically. However, while diabetes is a well-established risk factor for the development of several types of cancer, the role of cancer in the risk of developing diabetes has been difficult to establish. In our analysis of the Korean National Health Insurance Service–National Sample Cohort (NHIS-NSC), cancer development was associated with a subsequent increase in the risk of diabetes among patients without a prior history of diabetes, even after adjusting for major precancer risk factors for diabetes. Although we could not adjust for all risk factors for diabetes, the temporal pattern in our data is difficult to explain simply by shared risk factors between diabetes and cancer, and the pattern suggests that the risk of developing diabetes changes with the development of cancer.

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