In a nutshell
This article investigated the link between blood glucose control and long-term prostate cancer (PC) outcomes in men with diabetes mellitus (DM) who are having a radical prostatectomy (RP; complete removal of the prostate).
The authors concluded that a worse blood glucose control was associated with metastases and castration-resistant prostate cancer (CRPC; PC that does worsens in spite of hormonal therapy).
DM is a disorder where the body does not produce enough of the hormone insulin. This causes blood glucose to rise. It is known that high blood glucose slows the healing of wounds. Also, poorly controlled diabetes was associated with a more aggressive PC. However, the effect of blood glucose control (how well your blood glucose is managed) on the long-term outcomes of patients with PC treated with a RP remains under investigation. Blood glucose control (over the past 3 months) is measured through the HbA1c blood levels.
Methods & findings
The study involved 1409 men. 699 (50%) had an HbA1c under 6.5%, 631 (45%) had an HbA1c of 6.5% to 7.9%. The other 79 (6%) had an HbA1c of 8% and more. All men underwent a RP and were followed up at 6.8 years. The outcomes measured were biochemical disease recurrence (BCR; increasing levels of a cancer marker which means the cancer is worsening), metastases (the spread of the cancer from its original site to a different site in the body) and CRPC (the cancer is able to grow and continue to spread despite using hormone therapy).
There was no association between a higher HbA1c and BCR. However, a higher HbA1c level was associated with a 21% increase in the risk of having metastases. A higher HbA1c was also associated with a 27% increased risk of CRPC.
The bottom line
The authors concluded that a higher HbA1c was associated with metastases and CRPC.
The fine print
This study only measured HbA1c one time prior to RP. Longer-term glucose control studies are needed for stronger evidence.
Published By :
Apr 29, 2019
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