title: Shock wave lithotripsy and diabetes mellitus: a population-based cohort study.
abstract: OBJECTIVE
  To determine if shock wave lithotripsy (SWL) is associated with diabetes mellitus (DM) in a community setting. The pancreas is vulnerable to injury at SWL as evidenced by case studies; thus, concern exists for the development of DM after SWL.
  
  
  METHODS
  The Rochester Epidemiologic Project was used to identify all Olmsted County, Minnesota residents diagnosed with urolithiasis from 1985 to 2008. New-onset DM was identified by diagnostic codes and treatment with SWL by surgical codes. Cox proportional hazards models were used to determine the risk of DM after SWL therapy.
  
  
  RESULTS
  A total of 5287 incident cases of stone formation without pre-existing DM and with ≥3 months of follow-up. After an average follow-up of 8.7 years, 423 patients (8%) were treated with SWL and new-onset DM had developed in 743 (12%). The diagnosis of DM followed SWL in 77 patients. However, no association was evident between SWL and the development of DM before (hazard ratio 0.98, 95% confidence interval 0.76-1.26) or after (hazard ratio 0.92, 95% confidence interval 0.71-1.18) SWL, controlling for age, sex, and obesity.
  
  
  CONCLUSIONS
  In the present large, population-based cohort, the long-term risk of developing DM was not increased in persons who underwent SWL to treat their kidney stones.
authors.affiliation: Department of Urology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
authors.forename: Mitra
authors.initials: M
authors.lastname: de Cógáin
authors.forename: Amy E
authors.initials: AE
authors.lastname: Krambeck
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Rule
authors.forename: Xujian
authors.initials: X
authors.lastname: Li
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Bergstralh
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Gettman
authors.forename: John C
authors.initials: JC
authors.lastname: Lieske
mesh_terms: D000208:Acute Disease; D000328:Adult; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D058958:Organs at Risk; D010179:Pancreas / Q000293:injuries*; D010195:Pancreatitis / Q000209:etiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D052878:Urolithiasis / Q000453:epidemiology / Q000601:surgery*
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