In unadjusted analyses, the start of an OHG medication (HR, 2.96; 95% CI, 1.93-4.53) or insulin (HR, 5.28; 95% CI, 3.05-9.15) were both associated with pancreatic cancer development when compared to those with no change in use of these medications (Table 1, Supplementary Table 4). This evidence concerns the gene INS and familial pancreatic carcinoma.