Rationale of the Week | JR worried about cancer; sorting fact from fiction

For our June 8th Question of the Week, only 64% of respondents chose the best answer. We want to “take a closer look” at this question and determine strategies to choose the best response.

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question

Question: JR is taking Metformin 1000mg BID but is worried about getting cancer and is thinking about stopping the metformin. 

Which of the following is an accurate statement regarding diabetes and cancer?

Answer Choices:

  1. People with diabetes have a slightly lower risk of liver and uterine cancers.
  2. Some brands of metformin were recalled because of an NDMA impurity, so it is best to hold metformin for now.
  3. There is research suggesting that metformin may be associated with a decreased risk of certain cancers.
  4. Metformin does not increase the risk of cancer, but it can negatively impact renal function.

As shown above, the most common choice was option 3, the second most common answer was option 4, then option 2, and finally option 1.

Getting to the Best Answer

If you are thinking about taking the certification exam, the content of this practice test question will set you up for success. The exam will present questions that require test takers to be familiar with knowledge of diabetes co-conditions plus prevention and screening guidelines.

Answers & Rationale

Answer 1 is incorrect, 3.69% chose this answer, “People with diabetes have a slightly lower risk of liver and uterine cancers.” People with type 2 diabetes have a higher risk of getting liver and endometrial cancers. There is an increased risk of diabetes and cancer in the same person due to an overlap of risk factors (age and weight) plus lifestyle factors (smoking, activity level, income and environmental factors).

Answer 2 is incorrect, 6.77% of you chose this answer, “Some brands of metformin were recalled because of an NDMA impurity, so it is best to hold metformin for now.” In 2020, some brands of Metformin were recalled because of above acceptable levels of NDMA due to the manufacturing process. The FDA recalled those brands and they were pulled from pharmacy shelves. Any dispensed metformin post recall should be safe.

Answer 3 is Correct, 64.46% of you chose this answer, “There is research suggesting that metformin may be associated with a decreased risk of certain cancers.” YES, you chose the BEST answer. Congratulations. Multiple studies have examined metformin for its potential tumor and cancer fighting ability and it looks very promising. Read more here >>

Answer 4 is incorrect, 25.08% of you chose this answer, “Metformin does not increase the risk of cancer, but it can negatively impact renal function.” This answer is NOT correct. Metformin appears to reduce the risk of some cancers but does NOT harm kidney function. There has been a increase of misinformation about metformin over the past year. Metformin is not recommended for anyone with a GFR less than 30 due to increase risk of lactic acidosis. But, metformin WON’T harm the kidneys and one could even argue that it protects them by lowering A1C by 1-2% points. You can download our Medication PocketCards for more information.

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!


Level 4 | Cancer & Diabetes | 1.25 CEs

Patients with cancer often experience hyperglycemia secondary to treatment, which can increase risk of infection and compromise their nutritional status. In addition, recent research has identified the link between diabetes and cancer. Join us to learn more about this unexpected link and treatment strategies for steroid induced hyperglycemia using a case study approach.

Topics Include:

  • Discuss the relationship between cancer, hyperglycemia and insulin resistance.
  • State 3 benefits of normalizing glucose levels during chemotherapy.
  • Using a case study approach, discuss strategies to improve glucose levels and quality of life.

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