Increased cancer mortality in type 2 diabetes (ZODIAC-3)

Background: It is unclear whether there is a relationship between type two diabetes and cancer mortality. It also is unclear whether obesity and body mass index (BMI) are associated with cancer in type 2 diabetes patients. Patients and Methods: In 1998, 1,145 patients with type two diabetes mellitus were enrolled in the Zwolle Outpatient Diabetes project Intergrating Available Care (ZODIAC) study. In this project, general practitioners (GPs) were assisted by hospital-based diabetes specialist nurses. Vital status was assessed in September 2004. The cancer mortality rate was evaluated using standardized mortality ratio (SMR) and its association with BMI (kg/m(2)) and obesity (> 30 kg/m(2)) with the Cox proportional hazard ratio. Results: The median follow-up time was 5.8 years. A total of 335 patients had died, of whom 70 died from malignancy. The SMR for cancer mortality was 1.38.(95% CI 1.07-1.75). BM[ and obesity were not associated with cancer death. Conclusion: An increased cancer mortality rate was found in type two diabetes mellitus patients but there was no significant association between BM[ or obesity and cancer mortality.