Shock Wave Lithotripsy Not Associated With Development of Diabetes Mellitus at 6 Years of Follow-up

Abstract

To investigate the hypothesis that extracorporeal shock wave lithotripsy (ESWL) increases the incident risk of new-onset diabetes mellitus (DM). Studies have suggested that ESWL predisposes to DM. Using a mail survey, we collected data on the presence and onset of DM in 1947 patients treated with the Medstone-STS electrohydraulic lithotripter from 1999 to 2002. These patients were matched by age, sex, and body mass index to controls from the National Health and Nutrition Examination Survey (NHANES) database. Of the 1947 patients, 4% could not be matched and were excluded, leaving 1869 for analysis, of whom 60.0% were men. The mean age was 51.9 years at ESWL and the median follow-up was 6 years. The mean body mass index at the end of the study was 28.6 kg/m(2). At ESWL, 8.67% of matched patients had a diagnosis of DM. This had increased to 13.9% at the time of survey. In the NHANES group, 8.34% had DM at the time the ESWL group underwent treatment, and this had increased to 14.1% at the NHANES survey. Therefore, the rate of new DM cases in the ESWL group was similar to that in the NHANES group (5.2% vs 5.8%, respectively; P = .47). Multivariate analysis of the patient cohort confirmed that age, sex, body mass index, and family history correlated with development of DM and that the laterality of treatment and number of treatments or shocks given were not significant predictors of DM. The results of our study have shown that patients treated with ESWL do not develop DM at a greater rate than does the general population at 6 years of follow-up.