The influence of antidiabetic medications on the development and progression of prostate cancer

• Published in: Cancer epidemiology Vol. 36; no. 4; pp. e243 - e250
• Main Authors: Hitron, Anna, Adams, Val, Talbert, Jeff, Steinke, Doug
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-08-2012; Elsevier Limited
• Subjects: Aged; Cancer; Case-Control Studies; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Disease Progression; Epidemiology; Hematology, Oncology and Palliative Medicine; Humans; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; IGFR; Insulin; Insulin - adverse effects; Insulin - therapeutic use; Internal Medicine; Male; Men; Metformin - adverse effects; Metformin - therapeutic use; Prostate cancer; Prostate tumor; Prostatic Neoplasms - chemically induced; Prostatic Neoplasms - etiology; Prostatic Neoplasms - pathology; Retrospective Studies; Studies; Sulfonylurea Compounds - adverse effects; Sulfonylurea Compounds - therapeutic use; IGFR; Prostate tumor; Diabetes; Prostate cancer; Insulin
• ISSN: 1877-7821; 1877-783X
• DOI: 10.1016/j.canep.2012.02.005

Abstract Background The development of prostate tumors has been linked to co-morbid diabetes mellitus (DM) in several studies, potentially through the stimulation of insulin-like growth factor receptor (IGFR). This study evaluates the effect of anti-diabetic medication use on the development of high grade tumors and time to tumor progression compared to non-diabetics. Methods This retrospective, nested case control study identified patients with prostate cancer (PCa) from the Kentucky Medicaid Database. Cases were diagnosed with PCa and DM and using at least one of the following antidiabetic medications; sulfonylureas, insulin, metformin or TZDs. Cases were further stratified on their insulin exposure resulting from therapy. Controls were those with PCa without DM or any anti-diabetic medications. Results The use of metformin or TZDs trended toward decreased odds of high-grade tumors and decreased risk of progression, while sulfonylureas and high-dose insulin tended toward an increased odds of high-grade tumors and increase the risk of progression compared to non-diabetics. Conclusions Future studies should be conducted to further evaluate the effects of anti-diabetic medications on tumor grade and time to prostate cancer progression.