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We extracted data on Koreans with newly diagnosed diabetes and selected age- and sex-matched controls provided by the National Health Insurance Corporation. Incident PaC was defined as a new registration in the Korea Central Cancer Registry under ICD-10 C25 with admission history until 2015. During 19,429,617.1 person-years, 8,589 PaCs were identified in 1,005,409 subjects for diabetes group and 4,021,636 subjects for control group. The diabetes group showed more than a two-fold risk for PaC compared with the control group. Among antidiabetic medications, metformin, thiazolidinedione, and dipeptidyl peptidase-4 inhibitor exposure was associated with decreased risk for future PaC(hazard ratio[95% confidence interval]\u2009=\u20090.86[0.77\u20130.96], 0.82[0.68\u20130.98], 0.57[0.51\u20130.64], respectively), whereas sulfonylurea and insulin exposure was related to increased risk(hazard ratio[95% CI]\u2009=\u20091.73[1.57\u20131.91], 2.86[1.43\u20135.74], respectively) compared to subjects with no drug exposure. Moreover, subjects with dual exposure history to metformin plus thiazolidinedione or metformin plus dipeptidyl peptidase-4 inhibitor had a lower risk of PaC compared to metformin-only treated subjects. In conclusion, Korean adults with diabetes are at higher risk of PaC compared with nondiabetic individuals, and this risk may be modified by antidiabetic medications.<\/jats:p>","DOI":"10.1038\/s41598-018-27965-2","type":"journal-article","created":{"date-parts":[[2018,6,20]],"date-time":"2018-06-20T11:54:47Z","timestamp":1529495687000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["The influence of diabetes and antidiabetic medications on the risk of pancreatic cancer: a nationwide population-based study in Korea"],"prefix":"10.1038","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8211-2393","authenticated-orcid":false,"given":"Da Young","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hee","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanghyun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nam Hoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Jin","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6175-0225","authenticated-orcid":false,"given":"Kyung Mook","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sei Hyun","family":"Baik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4378-520X","authenticated-orcid":false,"given":"Nan Hee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji A.","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,6,26]]},"reference":[{"key":"27965_CR1","unstructured":"Society, A. 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