The effect of hormone therapies on the risk of type 2 diabetes

This study examined the effect of duration and different types of hormone therapy on the risk of developing type 2 diabetes in prostate cancer patients. Researchers concluded that the type and duration of hormone therapy significantly affected diabetes risk.

Hormone therapy is a common treatment used in prostate cancer. It targets the production of androgens, male hormones such as testosterone, and reduces their effect on cancer cell growth. Hormone therapy can involve the surgical removal of the testicles (also called orchiectomy) or drug therapy. Drug therapies either lower the production of testosterone in the body (GnRH agonists) or block the action of androgens (anti-androgens). 

As with many treatments, hormone therapy is associated with a number of side effects. There is some evidence to suggest that hormone therapy increases the risk of type 2 diabetes. Type 2 diabetes affects the way the body breaks down sugar in the blood and can lead to complications such as kidney disease, nerve damage, and heart disease. How different types of hormone therapies affect diabetes risk is still being investigated.

The aim of this study was to determine the link between different hormone therapies and diabetes risk in prostate cancer patients.

34,031 men with prostate cancer were included in this study. 64% received treatment with GnRH agonists. 9% underwent orchiectomy and were grouped together with the GnRH agonist group. 27% were treated with anti-androgens. The incidence of type 2 diabetes was compared to 167,205 men without prostate cancer.

The risk of diabetes was significantly increased for men treated with GnRH agonists/orchiectomy during the first 3 years of treatment. 1 to 1.5 years of treatment increased diabetes risk by 61%. This was 68% for 2 to 2.5 years and 42% for 2.5 to 3 years of treatment. After 3 to 4 years, diabetes risk was reduced to 17% and continued to decrease at 7 to 10 years.

Men who received anti-androgen treatment did not experience an increased risk of type 2 diabetes during any time period measured. Diabetes risk was comparable to men without prostate cancer.

Researchers concluded that hormone therapy significantly increased the risk of type 2 diabetes. Diabetes risk peaked after 3 years of treatment with GnRH agonists or orchiectomy.