title: Type 2 diabetes is an independent negative prognostic factor in patients undergoing surgical resection of a WHO grade I meningioma.
abstract: OBJECTIVE
  In recent years, there has been increased recognition of the relationship between type 2 diabetes mellitus (DM) and poor outcomes following a variety of surgical procedures. We sought to study the role of type 2 DM as a prognostic factor affecting the long-term survival of patients undergoing surgical resection of a WHO Grade I meningioma.
  
  
  METHODS
  We conducted a retrospective cohort study on 196 patients who had a WHO Grade I meningioma resected at our institution between 2001 and 2013. The medical record was reviewed to identify a pre-existing diagnosis of type 2 DM. Patient mortality was reviewed by medical record and Social Security Death Index (SSDI). Variables associated with survival in a univariate analysis were included in the multivariate Cox model if P<0.10. Variables with probability values >0.05 were then removed from the multivariate model in a step-wise fashion.
  
  
  RESULTS
  33 (17%) patients had pre-existing diagnoses of type 2 DM prior to clinical presentation. Mean survival time in diabetic patients was 52.1 months compared to 160.9 months in non-diabetics. The decreased survival rate and time in patients with type 2 DM were found to be statistically significant (p=0.008 and p<0.0001, respectively). In a multivariate Cox analysis, a pre-existing history of type 2 DM was independently associated with decreased survival following the resection of a WHO Grade I meningioma (HR=2.6, p=0.045).
  
  
  CONCLUSIONS
  A pre-existing diagnosis of type 2 DM is an independent negative prognostic indicator following the resection of a WHO Grade I meningioma.
authors.affiliation: Vanderbilt University Medical Center, 1161 21st Ave S, Rm T-4224 MCN, Nashville, TN 37232-2380, United States. Electronic address: nayeriarash@yahoo.com.
authors.forename: Arash
authors.initials: A
authors.lastname: Nayeri
authors.affiliation: Department of Neurosurgery, Vanderbilt University Medical Center, 1161 21 st Ave S, Rm T-4224 MCN, Nashville, TN 37232-2380, United States. Electronic address: Sillky.choati@vanderbilt.edu.
authors.forename: Silky
authors.initials: S
authors.lastname: Chotai
authors.affiliation: Vanderbilt University School of Medicine, 201 Light Hall, Nashville, TN 37232, United States. Electronic address: Marc.a.prablek@vanderbilt.edu.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Prablek
authors.affiliation: Department of Neurosurgery, Vanderbilt University Medical Center, 1161 21 st Ave S, Rm T-4224 MCN, Nashville, TN 37232-2380, United States. Electronic address: Philip.r.brinson@vanderbilt.edu.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Brinson
authors.affiliation: Vanderbilt University School of Medicine, 201 Light Hall, Nashville, TN 37232, United States. Electronic address: Diana.douleh@vanderbilt.edu.
authors.forename: Diana G
authors.initials: DG
authors.lastname: Douleh
authors.affiliation: Department of Neurosurgery, Vanderbilt University Medical Center, 1161 21 st Ave S, Rm T-4224 MCN, Nashville, TN 37232-2380, United States. Electronic address: Kyle.weaver@vanderbilt.edu.
authors.forename: Kyle D
authors.initials: KD
authors.lastname: Weaver
authors.affiliation: Department of Neurosurgery, Vanderbilt University Medical Center, 1161 21 st Ave S, Rm T-4224 MCN, Nashville, TN 37232-2380, United States. Electronic address: Reid.thompson@vanderbilt.edu.
authors.forename: Reid C
authors.initials: RC
authors.lastname: Thompson
authors.affiliation: Department of Neurosurgery, Vanderbilt University Medical Center, 1161 21 st Ave S, Rm T-4224 MCN, Nashville, TN 37232-2380, United States. Electronic address: Lola.chambless@vanderbilt.edu.
authors.forename: Lola
authors.initials: L
authors.lastname: Chambless
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D008579:Meningioma / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D060787:Neoplasm Grading; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012189:Retrospective Studies
keywords: Diabetes; Meningioma; Mortality; Obesity; Survival; WHO grade I