Influence of diabetes mellitus and anti-diabetic drugs on pathophysiology and prognosis for primary prostate cancer

DM is associated with a modestly lower incidence of prostate cancer, likely mediated by hormonal cross-talk and metabolic changes. Metformin may confer additional protection in a wide range of molecular mechanisms. Nevertheless, diabetes worsens treatment course-raising surgical morbidity and radiotherapy toxicity-necessitating tight metabolic control and thoughtful anti-diabetic drug selection.