Diabetes Mellitus Type 2: A Driving Force for Urological Complications

Type 2 diabetes mellitus (T2DM) is a growing epidemic associated with many adverse complications. Urological complications of diabetes mellitus in men are gaining recognition. Previously unknown associations between T2DM and risk for prostate cancer, bladder cancer, renal cell carcinomas, urinary tract infections, nephrolithiasis, penile lesions, androgen deficiency, and erectile dysfunction have been discovered. Significantly, metformin could play a role in the management of urological malignancies, and therapies used for management of these cancers could in return lead to increased risk for diabetes. In this review, we aim to bridge the gap between T2DM and urological complications by discussing the latest findings in these fields, with the ultimate goal being improved patient care on both fronts.

TrendsType 2 diabetes mellitus (T2DM) leads to decreased risk of prostate cancer. This is due to decreased levels of insulin with prolonged disease duration, decreased leptin levels, lower testosterone levels, genetic factors, and microvascular complications.Metformin use in diabetic men might lead to lower incidence of prostate, bladder, and kidney cancers. Pioglitazone use leads to increased risk of bladder cancer.T2DM leads to lower urinary tract symptoms, partly due to a lower number of interstitial cells in the detrusor muscle and lamina propria.T2DM is not an independent risk factor for increased complications from urinary tract infections.Androgen deficiency is not simply a consequence of T2DM. It, itself, leads to worsening glycemic control and increased risk of T2DM.