The incidence of diabetes and urologic diseases is widespread, and increases with age.1 Diabetes is a risk factor for kidney stones, associated with higher risk for bladder cancer in relatives as well as increased morbidity and mortality from kidney cancer compared with patients without diabetes, according to a study by Verde Ioana, MD, PhDc, Diabetes Specialist, Teaching Assistant, Theodor Burghele Clinical Hospital, Bucharest, Romania, and colleagues.
Bladder dysfunctions, sexual and erectile dysfunction, and urinary tract infections can have a significant negative impact on the quality of life of men and women with diabetes, and are the most common urologic complications in this patient population. In an observational, retrospective study, Dr Ioana and colleagues analyzed the characteristics of urinary disorders in patients with diabetes who were admitted to Theodor Burghele Clinical Hospital’s urology ward, and found that diabetes increased their risk for certain urologic diseases.
They analyzed urologic disorders in 6910 patients with (n = 1142) and without (n = 5768) diabetes who were admitted from January 2013 to July 2014. The average age of the patients included in the analysis was 60.01 years, and mean hospitalization duration was 6.52 days. The study authors initially analyzed the data of all patients, and then analyzed them in subgroups based on discharge with a confirmed diagnosis of kidney, bladder, or prostate cancer, prostate adenoma, and urinary lithiasis.
Results of the study indicated that patients with diabetes were at increased risk for certain urologic diseases (ie, bladder cancer, prostate adenoma, prostate and genital infections), prolonged hospitalizations, and certain features of laboratory analysis (ie, leukocytosis, decreased glomerular filtration rate). In patients with and without diabetes, urinary stones were the most frequent reason for hospitalization (28.5% vs 37.5%, respectively), and bladder cancer was the most common malignancy (60.55% vs 59.76%), followed by prostate cancer (28.30% vs 28.44%) and renal-cell carcinoma (11.93% vs 11.00%).
Diabetes prolonged hospitalization in patients with kidney stones, kidney cancer, and infectious pathology, and those with diabetes who were hospitalized for urinary stones, renal cancer, and infectious pathology were older than patients without diabetes (68.2 years vs 60.8 years; P <.05). Kidney, bladder, and prostate cancers were more common in patients with diabetes than in patients without diabetes (19.08% vs 15.98%, respectively), and their risk for bladder cancer was significantly increased (95% confidence interval, 1.01-1.51; P <.05). A total of 17 (70.8%) men had diabetes and renal cancer, whereas 64 (58.2%) were nondiabetic and had kidney cancer. For patients with diabetes and renal cancer, hospitalization lasted significantly longer than in patients with renal cancer who did not have diabetes (14.5 days vs 10.6 days; P <.05).
Dr Ioana and colleagues also found that, between patients with and without diabetes, there were no statistically significant differences in the frequencies of various types of cancer. Patients with diabetes who were hospitalized as a result of urologic pathologies frequently had leukocytosis and a lower estimated glomerular filtration rate than patients without diabetes. At admission, blood glucose levels did not positively correlate with the length of stay for the most-studied urologic disorders, and in prostate pathology cases (ie, prostate adenoma, acute prostatitis, and prostate adenocarcinoma), there were no significant differences between patients with and without diabetes regarding prostate-specific antigen value.
“In the group of analyzed patients, diabetes was a risk factor for malignant diseases and in particular for bladder cancer,” Dr Ioana and colleagues concluded. “Also, diabetes mellitus was positively associated with prostate adenoma and prostate and genital infections.”
- Verde I, Rusu E, Suliman E, et al. Diabetes in the hospitalized patients with urological diseases. J Med Life. 2015;8:496-501.