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Androgen-deprivation therapy and diabetes control among diabetic men with prostate cancer

Nancy L Keating1, Pang-Hsiang Liu2, A James O'Malley2

  • 1Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.

European Urology
|March 5, 2013
PubMed
Abstract

Insights

Androgen-deprivation therapy (ADT) worsens diabetes control in prostate cancer patients. Hemoglobin A1c levels increased with ADT, even with additional diabetes medications, indicating poorer glycemic management.

Area of Science:

  • Endocrinology
  • Oncology
  • Diabetes Mellitus Research

Background:

  • Androgen-deprivation therapy (ADT) for prostate cancer (PCa) is linked to reduced insulin sensitivity and higher diabetes risk in men without diabetes.
  • Limited data exist on ADT's impact on diabetes control in men already diagnosed with diabetes.

Purpose of the Study:

  • To investigate the effect of ADT on diabetes control in men with PCa and pre-existing diabetes.
  • To assess changes in hemoglobin A1c (HbA1c) and diabetes pharmacotherapy intensification.

Main Methods:

  • An observational cohort study utilized US Department of Veterans Affairs data.
  • 2237 pairs of propensity-matched men with PCa and diabetes were analyzed.
  • HbA1c levels and time to diabetes medication intensification were compared between ADT and no-ADT groups.

Main Results:

  • Mean HbA1c at baseline was 7.24% for both groups.
  • After 1 year, HbA1c increased to 7.38% in the ADT group and decreased to 7.14% in the no-ADT group (difference-in-differences: +0.24, p=0.008).
  • Similar trends were observed at 2 years, with increased HbA1c despite more diabetes medications in the ADT group (aHR: 1.20).

Conclusions:

  • ADT is associated with worsening glycemic control in men with prostate cancer and diabetes.
  • Increased HbA1c levels were observed despite the addition of diabetes medications.
  • Findings highlight the need for careful monitoring of diabetes in PCa patients undergoing ADT.
Keywords:
Androgen-deprivation therapyDiabetesProstate cancer

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