Rashed FK et al, 2017: Prevalence of diabetes mellitus after extra corporeal shock wave lithotripsy in 15 years follow-up.
Rashed FK, Ahmadi NR, Zolfaghari A, Farshi A, Amjadi M, Gholipour M.
Department of Urology, Imam Reza Hospital, Tabriz, Iran.
Department of Extracorporeal Shock Wave Lithotripsy, Shahid Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
General Practitioner at Imam Reza hospital, Tabriz, Iran.
OBJECTIVE: To investigate the hypothesis that extracorporeal shock wave lithotripsy (ESWL) increases the risk of new onset diabetes mellitus (DM) or significant changes in fasting blood sugar (FBS).
MATERIALS AND METHODS: A total number of 307 patients enrolled in this study. All of them had undergone ESWL for kidney stone from 1991 to 1994. In 2009, after 15-19 years, we invited patients to check their blood sugar.
RESULTS: There were 307 patients, 19.8% females, and 80.1% males. The mean age of the patients was 44 for females and 42 years for males. 47.5% had kidney stone in the left side, 42.9% in the right side and 9.4% bilateral. The mean FBS increasing was 11.86 g/dl. It was 14.54 g/dl for the right side, 8.57 g/dl for left and 16.24 g/dl for bilateral ESWL.
DISCUSSIONS: The increasing of FBS is more significant in shock wave intensities higher than 15.5 KV. And there wasn't any significant relationship between age, sex, body mass index (BMI) and total number of shock waves with increasing of FBS. ESWL treatment might associate with increasing FBS without any relation to age, sex and BMI.
Urol Ann. 2017 Jul-Sep;9(3):268-271. doi: 10.4103/0974-7796.210041. FREE ARTICLE
The question whether DM is a consequence of SWL obviously remains a continuous matter of debate.
The authors of this report claim that the results give support to the conclusion that SWL results in increased risk of DM. It is doubtful, however, if this study really supports this conclusion. Only 307 out of 1400 invited patients accepted the re-visit 15-19 years after SWL. Obviously also children were included in the study. There is, unfortunately, no control group and given the high risk of DM in patients with stone disease, it is difficult to draw conclusions on the reported increments in fasting blood sugar.