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Medical Forum / Diseases and Disorders / Prostate Cancer / February 2005

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Lupron and Diabetes

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Olfart - 19 Feb 2005 14:48 GMT
Hi Group,
After 13 months of Lupron, I finally got my URO to cut it out for a while
due to many nasty side effects. He seems to feel that I should do OK - of
course he will monitor PSA and Testosterone and if necessary I can go back
on the stuff again.
My question is this - I have been a type 2 diabetic for about 5 years. I
have always maintained good control with diet and excercise up until about 6
months ago. My blood glucose has crept up into the 120-150 range (Ha1c
6.5-7.0) and my Dr has been giving me fits. I have been a little lax in the
excercise dept due to the Lupron fatigue, but have watched my diet closely
and started taking Glucophage about a month ago. Also stopped Lupron at the
same time. My numbers are very slowly coming back down. My URO says it takes
about 2-3 months for the effects of the Lupron to leave my system.
I told my Dr  I had read that HT can cause a rise in blood glucose due to
the effect it can have on the liver's ability to process glucose. She
doesn't think this is a valid reason for the increase.
Are there any diabetics in the group who have had a similar problem with
glucose control while on AHT ??
I would appreciate any comments.  Thanks
George
Age - 69
8/12/02 - PSA 3.7
10/13/03 - PSA 4.69
11/11/03 - PSA 4.8
11/18/03 - Biopsy - 10 cores
one core-25% of core-Gleason 4+4=8
all other cores benign tissue
12/10/03 - Consult - Oncologist MD
12/16/03 - Consult - Radiation Oncologist
Treatment Plan - Northeast Ga Cancer Center
HT - started 12/17/03 - Eulixen & Lupron (2nd 4 mo Lupron-4/26)
2/10/04 - Started - Flowmax and Megastrol
Radiation - IMRT to begin 3/30/04 - 42 treatments - Completed 6/8/04
No seeds due to Prostate problems
8/30/04 - 1 yr Viadur Implant instead of 4mo Lupron
1/14/05 - Removed implant - trying intermittant HT for a while.
I.P. Freely - 19 Feb 2005 17:31 GMT
Exacerbation of diabetes, as well as arthritis and high blood lipids
(triglycerides, cholesterol), is a well-documented and frequent SE of ADT.
It can turn a lean, mean fat-burning machine into a pot-bellied,
insulin-resistant, pre-diabetic, or turn insulin resistance into full-blown
diabetes.

It BETTER FREAKING *NOT* take me months to get this single 28-day trial shot
of Zoladex out of my system! I hope that kind of delay is only after many
months on an LHRH. (9 days now since my trail shot, and the only two effects
are increased energy and better sleep. Makes sense, as our first few weeks
on ADT1 =>  increased testosterone.

I.P.

> After 13 months of Lupron, I finally got my URO to cut it out for a while
> due to many nasty side effects.
[quoted text clipped - 11 lines]
> Are there any diabetics in the group who have had a similar problem with
> glucose control while on AHT ??
Olfart - 19 Feb 2005 22:08 GMT
> Exacerbation of diabetes, as well as arthritis and high blood lipids
> (triglycerides, cholesterol), is a well-documented and frequent SE of ADT.
[quoted text clipped - 9 lines]
>
> I.P.

I'm surprised that your Dr didn't give you an anti-androgen such as Eulixen
before your shot. It helps prevent testosterone "flare" which is what you
are experiencing now and from what I'm told can be very troublesome to some.
I took Eulixen for 30 days before my first Lupron shot.
I.P. Freely - 20 Feb 2005 01:05 GMT
Flare threatens primarily those with symptomatic mets, particularly bone
pain. My doc knows I had none.

OTOH, I'm disappointed in myself AND him for not irradiating my pecs prior
to the Zoladex. That's inexcusable, since once the ADT starts, it's too late
to do any good. I'd REALLY be PO'd if I weren't 99.9% certain I'm not
getting another shot. Either way, I'm surely going to be asking him why that
wan't done.

OTOH, if this is all flare does to me, let me at it. I feel 20 years younger
and sleep much better than I have in years. I can see why many people take
T, HGH, and similar "youth restoring" drugs. If they were safe and didn't
feed PC, I'd be on 'em like Walsh on an RP.

I.P.

> "I.P. Freely" <fuhgeddaboutit@noway.not> wrote > >
> > It BETTER FREAKING *NOT* take me months to get this single 28-day trial
[quoted text clipped - 11 lines]
> are experiencing now and from what I'm told can be very troublesome to some.
> I took Eulixen for 30 days before my first Lupron shot.
Clarence Crow - 19 Feb 2005 19:08 GMT
>My blood glucose has crept up into the 120-150 range (Ha1c
>6.5-7.0) and my Dr has been giving me fits.
<snip>
>Are there any diabetics in the group who have had a similar problem with
>glucose control while on AHT ??
<snip>
>I would appreciate any comments.  Thanks
<snip>
I was dxd with PCA 09/04 at age 69 ,and then my Ha1c was in the low
5.x s
Now it's the same as yours, plus the PN in both my feet and ankles has
flared and the Osteo Arthritis in the same places and my R knee has
become unbearable. (I'm taking Tramadol 50mg in 2 pills/day spaced 6
hrs).

My PCa dx:
Orig PSA 15.0
DRE T2A upgraded to T2C by Rad Onc after reading Biopsy report
10 cores sampled,
4 @ (4+4) G8 - 2 @ 80% + 2 @ =< 40%
2 @ (3+4) G7 - 1 @ 30% + 1 @ 20%
2 @ no evidence
2 not reported on (misfires?)
PSA @ entry into treatment 21.0
Ha1c 6.8, Cholesterol & other things OK.
Scans revealed no Mets.

Treatment Regime started Nov 01/2004
10-12 wks on Dual HT (Lucrin 3 mthly & Androcur Tabs 2/day), similar
to Lupron and Casodex. Then revert to Lucrin only.
23 sessions of Conformal EBRT commencing 5 mths from entry.
8 wks rest
3 fractions of HDR Temp Brachytherapy in 48 hrs.
Lucrin to be maintained till 18 mths mark.

PSA so far 21.0 (entry) --- 2.4 (6 wks) - 0.45 (12 wks).
CT positioning scan for Rad on Mon Feb 21, 2005.

Hope this helps.

-- Reader to complete...
-- Please reply to this ng as my email adress is fake:

-- Regards

-- CC
No Spam - 22 Feb 2005 21:07 GMT
> After 13 months of Lupron, I finally got my URO to cut it out for a while
> due to many nasty side effects. He seems to feel that I should do OK - of
[quoted text clipped - 15 lines]
> I would appreciate any comments.  Thanks
> George

Good afternoon George,

I'm just back from the doc, the regular doc.  

About 10 months ago, I clocked a fasting blood sugar of 130, a1c
7.0. The doc said, "knock off some weight, get more exercise, we'll
keep an eye on this but handle the prostate cancer first."  

I weighed 197 pounds.

I had two 4 month Lupron shots, the IMRT, the seeding in September.
After the 2nd Lupron shot, the side effects started, hot flashes,
fatigue, thirst, some disorientation.  

After the seeding, I started getting up at night to pee, 2 or 3
times.  This went on for 3 months.  

I don't have the energy to exercise.  I used to walk a couple times
a week for a hour.  

The other week, I clocked a fasting blood sugar of 304 and an a1c of
11.9.   I weigh 185 now. BP 122/80 today, this is taking one Cozaar
a day.  

We did a random blood sugar, 297 a couple hours after eating.

I raised the Lupron issue but he doesn't buy it.  Doesn't think
Lupron is contributing to the sugar problem.  

I really suspect the Lupron but can't prove it.  


Olfart - 22 Feb 2005 22:08 GMT
> Good afternoon George,
>
[quoted text clipped - 26 lines]
>
> I really suspect the Lupron but can't prove it.

I'm inclined to agree with you. I've been off of Lupron for about 5 weeks.
The side effects are starting to diminish(hot flashes, fatigue, etc) and I'm
feeling 100% better. My Uro says it should take about 2-3 months to get the
Lupron out of my system. My blood glucose readings seem to be slowly going
down over the last few weeks. I'm going to bring this up with my Internist
when I see her next week for aaa Ha1c test. Have been taking 500mg
GlucophageXR for the last month-never needed the stuff before- always
controlled well with diet and excercise. I assume you are still on Lupron
for your BG to be so high. Take Care
George
Age - 69
8/12/02 - PSA 3.7
10/13/03 - PSA 4.69
11/11/03 - PSA 4.8
11/18/03 - Biopsy - 10 cores
one core-25% of core-Gleason 4+4=8
all other cores benign tissue
12/10/03 - Consult - Oncologist MD
12/16/03 - Consult - Radiation Oncologist
Treatment Plan - Northeast Ga Cancer Center
HT - started 12/17/03 - Eulixen & Lupron (2nd 4 mo Lupron-4/26)
2/10/04 - Started - Flowmax and Megastrol
Radiation - IMRT to begin 3/30/04 - 42 treatments - Completed 6/8/04
No seeds due to Prostate problems
8/30/04 - 1 yr Viadur Implant instead of 4mo Lupron
1/14/05 - Removed implant - trying intermittant HT for a while.
No Spam - 23 Feb 2005 00:00 GMT
> > Good afternoon George,
> >
[quoted text clipped - 37 lines]
> for your BG to be so high. Take Care
> George

The 3rd four month Lupron shot was scheduled for the end of January.
That also marks three months after the Palladium-103 seeding.

In November, December, and January, I was feeling beat.    I was
getting up a couple times a night to pee, more at first, less toward
the end.

I had a profound sense of fatigue that I attributed to the radiation
or the interrupted sleep.

I'm about 3 weeks past the date that the uro-doc would have given me
shot #3.  

In the last week, I felt like I was waking up.  Feeling stronger.

My primary care doc thinks that I am feeling better because he is
treating the diabetes with glucophage.  

I used to think that I was feeling better because the rad side
effects were fading.

Now I suspect the Lupron.  I'm guessing that the rad and the
glucophage are red herrings.

Thanks.  

I. P. Freely - 24 Feb 2005 05:05 GMT
Guys, extreme fatigue is probably THE best known, most likely, maybe most
pronounced effect of ADT/Lupron. It's what testosterone deprivation is all
about.

I.P.

"No Spam " <No Spam@Nospama.net> wrote >
> I had a profound sense of fatigue that I attributed to the radiation
> or the interrupted sleep.
[quoted text clipped - 4 lines]
> Now I suspect the Lupron.  I'm guessing that the rad and the
> glucophage are red herrings.
I. P. Freely - 24 Feb 2005 05:01 GMT
Shouldn't be too difficult, given this quote "Virtually all studies show
that low testosterone causes insulin resistance" from
http://www.avantlabs.com/page.php?pageID=177&issueID=16 . which, in turn,
came 0.19 seconds after I punched low < testosterone insulin > (without the
<>) into Google. After all, the whole purpose of ADT/Lupron is to zero out
our  testosterone, which causes insulin resistance, which becomes, or is . .
. diabetes. I'm sure if you follow that lead you'll find the proof your doc
needs . . . or that YOU need to change docs if he refuses rhe evidence.

I.P.

."No Spam " <No Spam@Nospama.net> wrote >
> I really suspect the Lupron but can't prove it.
ckh - 24 Feb 2005 12:03 GMT
> Shouldn't be too difficult, given this quote "Virtually all studies show
> that low testosterone causes insulin resistance" from
[quoted text clipped - 4 lines]
> . diabetes. I'm sure if you follow that lead you'll find the proof your doc
> needs . . . or that YOU need to change docs if he refuses rhe evidence.

Thanks,

I'll take a look.

The problem is that the PDR doesn't say that, in your face; there's
a only very brief mention.  

Another clue for me is that the Uro-doc was testing for spilling
sugar in my urine.

As for changing docs, nah. This guy is "good".   I've been following
him for 15-20 years.  He takes time to explain things.

Based on the info you found, I'm more certain that the Lupron caused
my 300 blood sugar.  That doesn't mean that I can go against the
doc, he has me on glucophage and wants me to do the needlestick,
diet and exercise thing.

With a 300 blood sugar, I can't mess around.  I've seen what happens
to out-of-control diabetics.  Blindness, lose a foot, mental
confusion.

What it does say is that very likely, I'll be able to get things
under control in about 2 months.  

My last 4 month Lupron shot was at the end of September 2004.  I was
supposed to have another at the end of January 2005.  I begged off
it arguing with the < 0.1 PSA in December 2004.

My next PSA will be next month, then I see the Rad-doc in April.

So what am I doing about the diabetes?   One glucophage a day,
increasing to two next week.  I cut the refined sugar, Pepsi's,
white bread, noodles to about 1/4.   More meats and cheese, complex
carbs like bean chili.  

In the last year, I've dropped 12 pounds, from 197 to 185.  This
time period included 2 four month Lupron shots and 2 weeks of
Decadron during which I ate everything in sight.  

On the third day on Decadron, I ate two steaks with scrambled eggs.

I'm aiming to get my weight down to 175, which is not emaciated.
I'm 5'7".   The rad-doc's dietician wants be down to 165.  

Forget that.  I'm not going for the pencil-necked geek look.

As the Lupron flushes out, I'm getting my stamina back.  It's slow
though.  I have never been this sick, frustrated, weak.  

<slamming fist on desk>  I am going to beat this thing!  
I. P. Freely - 24 Feb 2005 23:28 GMT
You're eating too much saturated fat. Even if you do beat the diabetes, your
diet will assist your Lupron in jacking your lipids way up. And are you
aware that "white bread" includes wheat bread, cracked wheat bread,
dark-colored bread, pasta, white rice, Idaho potatoes, pastries, almost
anything you can buy at 7-11, etc? If its first ingredient isn't whole wheat
flour or its fiber content is <3 g fiber per 45 grams of bread, it's. . .
white bread.

If this guy's so good, why didn't he know that ADT exacerbates existing
diabetes? Did he discuss its other SEs, including their potential severity,
likelihood, treatment, the TREATMENTS'  SEs, etc?

I.P.

"ckh" <nospam@nospam.com> wrote >
> The problem is that the PDR doesn't say that, in your face; there's
> a only very brief mention.
[quoted text clipped - 43 lines]
>
> <slamming fist on desk>  I am going to beat this thing!

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