Abstract
Introduction: Type 2 diabetes mellitus (T2DM) is a recognized risk factor for several cancers, however, its impact on hospitalization outcomes in patients with prostate cancer (PCa)—one of the most prevalent malignancies among men—remains unclear. Methods: A cross-sectional epidemiological study was conducted using data from the Spanish Minimum Basic Data Set. Hospital admissions with a primary diagnosis of PCa were analyzed (n = 144,210). Cases were stratified by the presence or absence of T2DM. Clinical and sociodemographic characteristics were compared between groups. Binary logistic regression was performed, with in-hospital mortality (IHM) as the dependent variable. Results: Patients with T2DM had a higher prevalence of vascular risk factors compared to non-diabetic counterparts. The presence of T2DM was associated with a 1.32-fold increase in IHM, while prolonged hospital stay was linked to a 3.25-fold increase in IHM (p < 0.001). Conclusion: T2DM is associated with increased in-hospital mortality and worse outcomes in patients hospitalized for PCa. These findings underscore the importance of targeted management strategies for patients with both conditions to reduce complications and improve prognosis.
1. Cancer IA for R on. Cancer Tomorrow [Internet]. World Health Organization (WHO) 2019 [cited 2020 Dec 31];1–2. Available from: https://gco.iarc.fr/tomorrow/en/dataviz/isotype?sexes=1&single_unit=50000&cancers=27&populations=935&group_populations=1&multiple_populations=1&age_start=8
2. BOE-A-2020-3692 Real Decreto 463/2020, de 14 de marzo, por el que se declara el estado de alarma para la gestión de la situación de crisis sanitaria ocasionada por el COVID-19 [Internet]. [Cited 2022 Oct 19]. Available from: https://www.boe.es/eli/es/rd/2020/03/14/463
3. Mottet N, van den Bergh RCN, Briers E, van den Broeck T, Cumberbatch MG, de Santis M, Fanti S, Fossati N, Gandaglia G, Gillessen S, Grivas N, Grummet J, et al. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer—2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol 2021;79:243–62.
4. Schaschinger T, Niederegger T, Brandt J, et al. Preoperative Hemoglobin A1C, Glycemic Status, and Postoperative Outcomes in General Surgery. JAMA Surg. 2026;161(1):39–49. https://doi.org/10.1001/jamasurg.2025.4706
5. Cruz Arévalo A, Gómez JE, Cárdenas AM, Reyes JC, Duarte RA. Predictive factors of infectious complications in patients undergoing prostatectomy. Urol Colomb [Internet] 2017 [cited 2022 Oct 6];26:104–9. Available from: https://www.elsevier.es/es-revista-urologia-colombiana-398-articulo-predictive-factors-infectious-complications-in-S0120789X17300217
6. Murphy L, Sherifali D, Ali MU, Ibrahim S. Influence of diabetes mellitus on oncological outcomes for patients living with cancer. sci diabetes self manag care. 2023;49(2):163–179. https://doi.org/10.1177/26350106231153073
7. Raychaudhuri R, Lin DW, Montgomery RB. Prostate cancer: a review. JAMA. 2025;333(16):1433–1446. https://doi.org/10.1001/jama.2025.0228
8. Adzavon YM, Culig Z, Sun Z. Interactions between androgen and IGF1 axes in prostate tumorigenesis. Nat Rev Urol. 2025;22(5):268–275. https://doi.org/10.1038/s41585-024-00942-3
9. Ministerio de Sanidad - Portal Estadístico del SNS - Registro de Altas de los Hospitales del Sistema Nacional de Salud. CMBD [Internet]. [Cited 2022 Oct 29]. Available from: https://www.sanidad.gob.es/estadEstudios/estadisticas/cmbdhome.htm
10. Health, United States. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-CM) [Internet]. [Cited 2022 Dec 20]. Available from: https://www.cdc.gov/nchs/hus/sources-definitions/icd-cm.htm#:~:text=International%20Classification%20of%20Diseases%2C%20Ninth,causes%20of%20injury%20and%20poisoning.
11. INE. Instituto Nacional de Estadística [Internet]. [Cited 2022 Nov 6]. Available from: https://www.ine.es/index.htm
12. Soriguer F, Goday A, Bosch-Comas A, et al. Prevalence of diabetes mellitus and impaired glucose regulation in Spain: the Di@bet.es Study. Diabetologia. 2012;55(1):88–93. https://doi.org/10.1007/s00125-011-2336-9
13. Arteaga JM, Latorre-Santos C, Ibáñez-Pinilla M, et al. prevalence of type 2 diabetes, overweight, obesity, and metabolic syndrome in adults in Bogotá, Colombia, 2022–2023: a cross sectional population survey. Ann Glob Health. 2024;90(1):67. Published 2024 Nov 11. https://doi.org/10.5334/aogh.4539
14. Mendivil CO, Gutiérrez Romero SA, Peláez-Jaramillo MJ, Nieves-Barreto LD, Montaño-Rodríguez A, Betancourt-Villamizar E. Diabetes and associated dietary intake among urban adults: COPEN (Colombian Nutritional Profiles)-a cross-sectional study. BMJ Open. 2021;11(6):e042050. https://doi.org/10.1136/bmjopen-2020-042050
15. Kelkar S, Oyekunle T, Eisenberg A, et al. Diabetes and Prostate Cancer Outcomes in Obese and Nonobese Men After Radical Prostatectomy. JNCI Cancer Spectr. 2021;5(3):pkab023. https://doi.org/10.1093/jncics/pkab023
16. González-Pascual M, Barea R. Prevalence of vascular risk factors in patients with and without type 2 diabetes mellitus admitted to hospital for stroke in the 2011-2013 period. Prevalencia de los factores de riesgo vascular entre los casos con diabetes mellitus tipo 2 y sin diabetes hospitalizados de 2011 a 2013 por accidentes cerebrovasculares. Endocrinol Diabetes Nutr (Engl Ed). 2019;66(3):150–6. https://doi.org/10.1016/j.endinu.2018.10.008
17. González-Juanatey C, Anguita-Sánchez M, Barrios V, et al. major adverse cardiovascular events in coronary type 2 diabetic patients: identification of associated factors using electronic health records and natural language processing. J Clin Med. 2022;11(20):6004. https://doi.org/10.3390/jcm11206004
18. Gravina G, Ferrari F, Nebbiai G. The obesity paradox and diabetes. Eat Weight Disord. 2021;26(4):1057–68. https://doi.org/10.1007/s40519-020-01015-1
19. Deol ES, Lehner KS, Fadel AE, et al. Impact of obesity on prostatectomy outcomes: Insights from a large prospectively maintained cohort. Urol Oncol. 2025;43(5):334.e7-334.e15. https://doi.org/10.1016/j.urolonc.2025.01.01
20. Darbà J, Ascanio M. Prostate cancer in Spain: a retrospective database analysis of hospital incidence and the direct medical costs. PLoS One. 2024;19(3):e0298764. https://doi.org/10.1371/journal.pone.0298764
21. Lee H, Byun SS, Lee SE, Hong SK. Impact of poor glycemic control upon clinical outcomes after radical prostatectomy in localized prostate cancer. Sci Rep. 2021;11(1):12002. https://doi.org/10.1038/s41598-021-91310-3

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Montserrat González-Pascual

