Risk of New-Onset Diabetes after Androgen Deprivation Therapy for Prostate Cancer in the Asian Population

Background: The associations of androgen deprivation therapy (ADT) with its adverse events in the Asian population remained largely unknown. We investigated the risk of new-onset diabetes mellitus (DM) after ADT for prostate cancer in the Asian population. Methods: All prostate cancer patients who were treated primarily with radical prostatectomy or radiotherapy, with or without further ADT from 2000 to 2009 were reviewed. Clinical parameters including age, clinical T stage, Gleason score, hypertension, dyslipidemia, impaired fasting glucose, ischemic heart disease, history of stroke, new-onset DM, follow-up duration, form and duration of ADT were reviewed. The risk of DM after ADT was analyzed with Kaplan-Meier method and multivariate Cox regression analysis. Results: A total of 388 patients were included, consisting of 169 patients in the non-ADT group and 219 patients in the ADT group. Upon Kaplan-Meier analysis, the ADT group had a higher risk of new-onset DM (P=0.011). Upon multivariate Cox regression analysis, dyslipidemia (HR 2.32, 95% CI 1.07-5.00, P=0.032), impaired fasting glucose (HR 5.92, 95% CI 1. 2.27-15.45, P<0.001) and the use of ADT in the form of GnRH agonist (HR 3.34, 95% CI 1.19-9.39, P=0.022) and bilateral orchiectomy (HR 6.49, 95% CI 1.48-28.55, P=0.013) were associated with increased risk of new-onset DM. Conclusions: There was increased risk of new-onset DM after ADT for prostate cancer in the Asian population. Regular screening of DM can be considered after the initiation of ADT, especially in patients with known history of dyslipidemia and impaired fasting glucose.