OBJECTIVE To assess whether initiation of insulin glargine (glargine), compared with initiation of neutral protamine Hagedorn (NPH) or insulin detemir (detemir), was associated with an increased risk of breast cancer in women with diabetes. RESEARCH DESIGN AND METHODS This was a retrospective new-user cohort study of female Medicare beneficiaries aged ≥65 years initiating glargine (203,159), detemir (67,012), or NPH (47,388), from September 2006 to September 2015, with follow-up through May 2017. Weighted Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs for incidence of breast cancer according to ever use, cumulative duration of use, cumulative dose of insulin, length of follow-up time, and a combination of dose and length of follow-up time. RESULTS Ever use of glargine was not associated with an increased risk of breast cancer compared with NPH (HR 0.97; 95% CI 0.88-1.06) or detemir (HR, 0.98; 95% CI 0.92-1.05). No increased risk was seen with glargine use compared with either NPH or detemir by duration of insulin use, length of follow-up, or cumulative dose of insulin. No increased risk of breast cancer was observed in medium- or high-dose glargine users compared with low-dose users. CONCLUSIONS Overall, glargine use was not associated with an increased risk of breast cancer compared with NPH or detemir in female Medicare beneficiaries.

中文翻译：

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服用甘精胰岛素，地特米尔和NPH胰岛素的65岁以上女性中类似的乳腺癌风险。

目的为了评估与中性鱼精蛋白Hagedorn（NPH）或胰岛素地特米尔（detemir）相比，开始使用甘精胰岛素（甘精胰岛素）是否与糖尿病女性患乳腺癌的风险增加相关。研究设计和方法这是一项针对2006年9月至2015年9月开始使用甘精胰岛素（203,159），地特米尔（67,012）或NPH（47,388）的65岁以上女性医疗保险受益人的回顾性新用户队列研究。 2017年5月。加权Cox比例风险回归用于根据以往使用情况，累计使用时间，累计胰岛素剂量，随访时间长短和使用时间来估计乳腺癌发病率的风险比（HRs）和95％CI。剂量和随访时间的长短相结合。结果与使用NPH（HR 0.97; 95％CI 0.88-1.06）或Detemir（HR，0.98; 95％CI 0.92-1.05）相比，曾经使用甘精胰岛素与乳腺癌风险增加无关。相比于NPH或地特米尔，使用甘精胰岛素的患者在使用胰岛素的持续时间，随访时间或胰岛素累积剂量方面均未见增加的风险。与中低剂量的甘精胰岛素使用者相比，未观察到乳腺癌风险的增加。结论总体而言，与女性健康保险受益人的NPH或Detemir相比，使用甘精胰岛素与乳腺癌风险增加无关。或累积剂量的胰岛素。与中低剂量的甘精胰岛素使用者相比，未观察到乳腺癌风险的增加。结论总体而言，与女性健康保险受益人的NPH或Detemir相比，使用甘精胰岛素与乳腺癌风险增加无关。或累积剂量的胰岛素。与中低剂量的甘精胰岛素使用者相比，未观察到乳腺癌风险的增加。结论总体而言，与女性健康保险受益人的NPH或Detemir相比，使用甘精胰岛素与乳腺癌风险增加无关。