Risk of new-onset diabetes mellitus and worsening glycaemic variables for established diabetes in men undergoing androgen-deprivation therapy for prostate cancer

Ithaar H. Derweesh, Christopher J. DiBlasio, Matt C. Kincade, John B. Malcolm, Kimberly D. Lamar, Anthony Patterson, Abbas E. Kitabchi, Robert Wake

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To investigate the incidence of new-onset diabetes mellitus (NODM) and of worsening glycaemic control in established DM after starting androgen-deprivation therapy (ADT) for prostate cancer, as ADT is associated with altered body composition, potentially influencing insulin sensitivity. PATIENTS AND METHODS: We retrospectively reviewed patients receiving ADT for prostate cancer at our institution between January 1989 and July 2005; those with incomplete information and those receiving only neoadjuvant ADT were excluded. Variables examined included age, race, body mass index (BMI), pretreatment prostate-specific antigen, Gleason sum, clinical stage, ADT type (medical vs surgical) and schedule (continuous vs intermittent), presence of pre-existing DM, serum glucose and glycosylated haemoglobin (HbA1c) levels before and after ADT, and receipt of vitamin D or bisphosphonate supplementation. Data were analysed statistically and P < 0.05 considered to indicate significance. RESULTS: In all, 396 patients (median age 73.2 years; median BMI of 26.7 kg/m2 at ADT initiation) were analysed. Of these, 59.1% were African-American and 40.9% were Caucasian/other. At a median follow-up of 60.1 months, 36 (11.3%) patients developed NODM. In 77 patients with pre-existing DM, there was an increase of ≥10% in serum HbA1c or fasting glucose levels in 15 (19.5%) and 22 (28.6%), respectively. On multivariate analysis, a BMI of ≥30 kg/m2 was associated with an increased risk of developing NODM (odds ratio 4.65, P = 0.031). Receipt of vitamin D had a protective effect (odds ratio 5.75, P = 0.017). CONCLUSIONS: Patients receiving ADT for prostate cancer with or with no history of DM should have routine surveillance of glycaemic control, particularly when their BMI is ≥ 30 kg/m2, with appropriate preventive and treatment measures.

Original languageEnglish (US)
Pages (from-to)1060-1065
Number of pages6
JournalBJU International
Volume100
Issue number5
DOIs
StatePublished - Nov 1 2007

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Androgens
Prostatic Neoplasms
Diabetes Mellitus
Body Mass Index
Therapeutics
Vitamin D
Odds Ratio
Glucose
Glycosylated Hemoglobin A
Diphosphonates
Prostate-Specific Antigen
Body Composition
Serum
African Americans
Insulin Resistance
Fasting
Appointments and Schedules
Multivariate Analysis
Incidence

All Science Journal Classification (ASJC) codes

  • Urology

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Risk of new-onset diabetes mellitus and worsening glycaemic variables for established diabetes in men undergoing androgen-deprivation therapy for prostate cancer. / Derweesh, Ithaar H.; DiBlasio, Christopher J.; Kincade, Matt C.; Malcolm, John B.; Lamar, Kimberly D.; Patterson, Anthony; Kitabchi, Abbas E.; Wake, Robert.

In: BJU International, Vol. 100, No. 5, 01.11.2007, p. 1060-1065.

Research output: Contribution to journalArticle

Derweesh, Ithaar H. ; DiBlasio, Christopher J. ; Kincade, Matt C. ; Malcolm, John B. ; Lamar, Kimberly D. ; Patterson, Anthony ; Kitabchi, Abbas E. ; Wake, Robert. / Risk of new-onset diabetes mellitus and worsening glycaemic variables for established diabetes in men undergoing androgen-deprivation therapy for prostate cancer. In: BJU International. 2007 ; Vol. 100, No. 5. pp. 1060-1065.
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T1 - Risk of new-onset diabetes mellitus and worsening glycaemic variables for established diabetes in men undergoing androgen-deprivation therapy for prostate cancer

AU - Derweesh, Ithaar H.

AU - DiBlasio, Christopher J.

AU - Kincade, Matt C.

AU - Malcolm, John B.

AU - Lamar, Kimberly D.

AU - Patterson, Anthony

AU - Kitabchi, Abbas E.

AU - Wake, Robert

PY - 2007/11/1

Y1 - 2007/11/1

N2 - OBJECTIVE: To investigate the incidence of new-onset diabetes mellitus (NODM) and of worsening glycaemic control in established DM after starting androgen-deprivation therapy (ADT) for prostate cancer, as ADT is associated with altered body composition, potentially influencing insulin sensitivity. PATIENTS AND METHODS: We retrospectively reviewed patients receiving ADT for prostate cancer at our institution between January 1989 and July 2005; those with incomplete information and those receiving only neoadjuvant ADT were excluded. Variables examined included age, race, body mass index (BMI), pretreatment prostate-specific antigen, Gleason sum, clinical stage, ADT type (medical vs surgical) and schedule (continuous vs intermittent), presence of pre-existing DM, serum glucose and glycosylated haemoglobin (HbA1c) levels before and after ADT, and receipt of vitamin D or bisphosphonate supplementation. Data were analysed statistically and P < 0.05 considered to indicate significance. RESULTS: In all, 396 patients (median age 73.2 years; median BMI of 26.7 kg/m2 at ADT initiation) were analysed. Of these, 59.1% were African-American and 40.9% were Caucasian/other. At a median follow-up of 60.1 months, 36 (11.3%) patients developed NODM. In 77 patients with pre-existing DM, there was an increase of ≥10% in serum HbA1c or fasting glucose levels in 15 (19.5%) and 22 (28.6%), respectively. On multivariate analysis, a BMI of ≥30 kg/m2 was associated with an increased risk of developing NODM (odds ratio 4.65, P = 0.031). Receipt of vitamin D had a protective effect (odds ratio 5.75, P = 0.017). CONCLUSIONS: Patients receiving ADT for prostate cancer with or with no history of DM should have routine surveillance of glycaemic control, particularly when their BMI is ≥ 30 kg/m2, with appropriate preventive and treatment measures.

AB - OBJECTIVE: To investigate the incidence of new-onset diabetes mellitus (NODM) and of worsening glycaemic control in established DM after starting androgen-deprivation therapy (ADT) for prostate cancer, as ADT is associated with altered body composition, potentially influencing insulin sensitivity. PATIENTS AND METHODS: We retrospectively reviewed patients receiving ADT for prostate cancer at our institution between January 1989 and July 2005; those with incomplete information and those receiving only neoadjuvant ADT were excluded. Variables examined included age, race, body mass index (BMI), pretreatment prostate-specific antigen, Gleason sum, clinical stage, ADT type (medical vs surgical) and schedule (continuous vs intermittent), presence of pre-existing DM, serum glucose and glycosylated haemoglobin (HbA1c) levels before and after ADT, and receipt of vitamin D or bisphosphonate supplementation. Data were analysed statistically and P < 0.05 considered to indicate significance. RESULTS: In all, 396 patients (median age 73.2 years; median BMI of 26.7 kg/m2 at ADT initiation) were analysed. Of these, 59.1% were African-American and 40.9% were Caucasian/other. At a median follow-up of 60.1 months, 36 (11.3%) patients developed NODM. In 77 patients with pre-existing DM, there was an increase of ≥10% in serum HbA1c or fasting glucose levels in 15 (19.5%) and 22 (28.6%), respectively. On multivariate analysis, a BMI of ≥30 kg/m2 was associated with an increased risk of developing NODM (odds ratio 4.65, P = 0.031). Receipt of vitamin D had a protective effect (odds ratio 5.75, P = 0.017). CONCLUSIONS: Patients receiving ADT for prostate cancer with or with no history of DM should have routine surveillance of glycaemic control, particularly when their BMI is ≥ 30 kg/m2, with appropriate preventive and treatment measures.

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