Study finds ADT increases risk of new-onset diabetes

Initiating androgen deprivation therapy (ADT) in men with prostate cancer significantly increases the risk of incident diabetes, and that effect occurs within a relatively short time frame, according to research presented here yesterday.

To investigate an association between ADT and the development of diabetes, investigators used a retrospective claims database that includes more than five million patients. Researchers identified men who were diagnosed with prostate cancer between May 2000 and March 2005, and who were in the database for at least 6 months prior to that index date with no diagnosis of diabetes and for at least 12 months after prostate cancer diagnosis. Those men were then divided into two cohorts according to whether they did or did not receive ADT.

The ADT (n=1,231) and no ADT (n=7,250) groups were compared for the development of diabetes during the post-index date period in a multivariate logistic regression analysis controlling for a wide range of potential confounding factors that could impact the probability of being newly diagnosed with diabetes. The results showed that demographic characteristics, comorbid conditions, and receipt of ADT affected the probability of incident diabetes. In the multivariate analysis, the men receiving ADT had a 43% increased risk of developing incident diabetes (p=.0065) within 1 year relative to their counterparts not receiving hormonal therapy.

"There is increasing recognition that ADT has adverse physiological effects, and recent research has shown that its use increases the risk of developing metabolic syndrome. Our study goes one step further and shows ADT increases the risk of overt clinical diabetes," said co-author Richard A. Markus, MD, PhD, of Oncology Supportive Care, Amgen, Thousand Oaks, CA.

"Our analyses have some limitations inherent in using a single claims database, and we lacked information on prostate cancer grade, stage, and diet, but the results reinforce that although ADT is a mainstay of treatment for men diagnosed with metastatic or locally advanced prostate cancer, physicians must weigh its potential benefits along with its serious side effects."

The study was supported by Amgen and conducted by HealthMetrics Outcomes Research, Groton, CT.