title: Retrospective analysis of the effects of steroid therapy and antidiabetic medication on survival in diabetic glioblastoma patients.
abstract: OBJECTIVE
  Type 2 diabetes mellitus (DM2) affects 10% of the population, but little is known about how DM2 and antidiabetic medication impact glioblastoma (GBM) patients.
  
  
  METHODS
  We retrospectively reviewed GBM patients with DM2 seen at a single institution from 1998 to 2010.
  
  
  RESULTS
  Of 988 GBMs, 124 (12.6%) were affected by DM2. Thirty-four developed DM2 after steroid use and 89 had pre-existing DM2. Median overall survival among diabetic GBMs was 10 months compared with 13 months among nondiabetics. Only 15% of diabetic patients achieved sustained steroid taper. Sixty-seven (54%) were managed with a single antidiabetic medication and, within this monotherapy group, Karnofsky Performance Score, resection status, steroid dependency and metformin use were the most important predictors of survival on multivariate analysis.
  
  
  CONCLUSIONS
  The prevalence of DM2 among GBMs is similar to that of the general population. A more aggressive approach to steroid tapering and the choice of antidiabetic drug may improve survival within this patient population.
authors: Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
authors: Mary R
authors: MR
authors: Welch
authors: Christian
authors: C
authors: Grommes
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001932:Brain Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D005909:Glioblastoma / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D017567:Karnofsky Performance Status; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage* / Q000009:adverse effects; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; D007004:Hypoglycemic Agents; D013256:Steroids; D013453:Sulfonylurea Compounds; D008687:Metformin