THU372 Finasteride Induced Hyperglycemia

Abstract

Abstract Disclosure: V. Bose: None. D.S. Martinez: None. Objective: Finasteride is a 5-alpha reductase inhibitor that is often prescribed to treat benign prostatic hyperplasia in men. It prevents the conversion of testosterone to dihydrotestosterone. Dihydrotestosterone has numerous physiological actions including having effects on physiological function of liver and pancreatic β-cells. While the medicine does not have hyperglycemia as an adverse effect on its profile, this is a case presentation of worsening hyperglycemia in a diabetic patient who was started on 5-alpha reductase inhibitor. Methods: The patient’s clinical course with laboratory data is presented. Results: The patient is a 69 year old obese male presented for hyperglycemia management. He had been treated with GLP1 agonist, SGLT2i and NPH. He noted that since starting finasteride in 2018, his fingerstick glucose levels were higher compared to prior readings. His hemoglobin A1c was also noted to have increased from 7% to 8.2%. He also reported some weight gain. Conclusion: In this case, one can see that the use of 5-alpha reductase inhibitor precipitated worsening hyperglycemia. The inhibition of androgens to their various metabolites may result in pathophysiological states that present as hyperglycemia via insulin resistance and liver disturbances. In patients with diabetes, the addition of finasteride or dutasteride should be cautiously monitored and if possible, avoided to limit worsening hyperglycemia and diabetic complications. Reference: Traish AM. Health Risks Associated with Long-Term Finasteride and Dutasteride Use: It's Time to Sound the Alarm. World J Mens Health. 2020 Jul;38(3):323-337. doi: 10.5534/wjmh.200012. Epub 2020 Mar 20. PMID: 32202088; PMCID: PMC7308241. Presentation: Thursday, June 15, 2023