Unlike our results, which showed that the group of diabetic patients treated with sulfonylureas had a higher than expected gastric cancer risk (SIR 1.31, 95% CI: 1.04–1.65), Chang et al. found that sulfonylurea had no effect on gastric cancer risk (crude OR 0.85; 95% CI: 0.64–1.12), meanwhile insulin treatment increased the risk of gastric cancer (crude OR 2.43 95% CI: 1.89–3.13) [25]. Here, INS is linked to gastric cancer.