Retrospective analysis of the effects of steroid therapy and antidiabetic medication on survival in diabetic glioblastoma patients

回顾性分析类固醇治疗和抗糖尿病药物对糖尿病胶质母细胞瘤患者生存率的影响

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Abstract

AIMS: Type 2 diabetes mellitus (DM2) affects 10% of the population, but little is known about how DM2 and antidiabetic medication impact glioblastoma (GBM) patients. 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. CONCLUSION: 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.

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