New-onset diabetes after androgen-deprivation therapy for prostate cancer: A nationwide propensity score-matched four-year longitudinal cohort study

Introduction: Androgen-deprivation therapy (ADT) is important in the treatment of prostate cancer. However, the relationship between ADT and the risk of diabetes remains unclear, and the association between duration and types of ADT has not been fully investigated. Aim: To examine the risk of developing type 2 diabetes mellitus (T2DM) in men who underwent ADT for prostate cancer. Methods: Data were collected retrospectively from the Longitudinal Health Insurance Database of Taiwan. In total, 4604 prostate cancer patients ≥40 years old who underwent ADT were included in the study cohort, and 4604 prostate cancer patients without ADT were included as controls, after adjusting for age and other comorbidities. Results: During the four-year follow-up period, the incidence of new-onset T2DM was 27.49 and 11.13 per 1000 person-years in the ADT and ADT-never cohorts, respectively. The ADT cohort was 2.19 times more likely to develop T2DM than the control group (95% CI 1.90–2.53, P < 0.001). Furthermore, the association was particularly striking in the subgroup of patients receiving complete androgen blockade (adjusted HR 2.33, 95% CI 1.96–2.78, P < 0.001). Conclusions: Men with prostate cancer who received ADT are at risk for developing diabetes.