title: The influence of antidiabetic medications on the development and progression of prostate cancer.
abstract: BACKGROUND
  The development of prostate tumors has been linked to co-morbid diabetes mellitus (DM) in several studies, potentially through the stimulation of insulin-like growth factor receptor (IGFR). This study evaluates the effect of anti-diabetic medication use on the development of high grade tumors and time to tumor progression compared to non-diabetics.
  
  
  METHODS
  This retrospective, nested case control study identified patients with prostate cancer (PCa) from the Kentucky Medicaid Database. Cases were diagnosed with PCa and DM and using at least one of the following antidiabetic medications; sulfonylureas, insulin, metformin or TZDs. Cases were further stratified on their insulin exposure resulting from therapy. Controls were those with PCa without DM or any anti-diabetic medications.
  
  
  RESULTS
  The use of metformin or TZDs trended toward decreased odds of high-grade tumors and decreased risk of progression, while sulfonylureas and high-dose insulin tended toward an increased odds of high-grade tumors and increase the risk of progression compared to non-diabetics.
  
  
  CONCLUSIONS
  Future studies should be conducted to further evaluate the effects of anti-diabetic medications on tumor grade and time to prostate cancer progression.
authors.affiliation: Department of Pharmacy, Jewish Hospital/St. Mary's Healthcare, Louisville, KY 40202, USA. anna.hitron@jhsmh.org
authors.forename: Anna
authors.initials: A
authors.lastname: Hitron
authors.forename: Val
authors.initials: V
authors.lastname: Adams
authors.forename: Jeff
authors.initials: J
authors.lastname: Talbert
authors.forename: Doug
authors.initials: D
authors.lastname: Steinke
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D018450:Disease Progression; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use; D011471:Prostatic Neoplasms / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds; D008687:Metformin