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After propensity score matching against multiple antidiabetic drug classes (insulin, metformin, SGLT-2 inhibitors, DPP-4 inhibitors, sulfonylureas), results showed: No significant increase in thyroid cancer incidence Median follow-up of ~4.5 years Risk estimates comparable or lower than other glucose-lowering therapies Overall, current epidemiological evidence does not support a clinically meaningful increase in thyroid cancer risk in humans

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In addition, polytherapy showed a significant reduction in hyperinsulinemia and an improvement in fasting glucose levels