Sugar and Stones Does diabetes mellitus influence the management and outcomes of patients treated surgically for urolithiasis in United Kingdom?

Main Article Content

Mohammed Elhadi https://orcid.org/0000-0001-6752-0383
J D’Costa
C De Vogel
Raghuram Devarajan
Ugo Otite

Keywords

Urolithiasis, metabolic syndrome, diabetes, stone recurrence, stone formation, complications

Abstract


Urolithiasis is a common urological problem in the United Kingdom. 6% of the adult population were diag-nosed with diabetes in England in 2013. Researchers suggest the association of diabetes with stone forma-tion, recurrence, and morbidity. This study aimed to compare the prevalence of risk factors like metabolic syndrome, urinary tract infections, age, gender and ethnicity among diabetics versus non-diabetics and to determine how diabetes affects the biochemical and surgical outcomes of urolithiasis.


Methods
There were182 patients treated surgically for urolithiasis between January 2010 and December 2012 were retrospectively analyzed. Information was cross-referenced with electronic notes to produce biochemical and surgical data.


Results
A total of 31 (17%) patients had type 2 diabetes. The mean age of diabetics was significantly higher than non-diabetics by nearly 12 years (p-value < 0.001). Hypertension, hyperlipidaemia, obesity and UTIs were more prevalent among diabetics (p-value < 0.001, < 0.001, 0.01, 0.009 respectively). Diabetics had signifi-cantly bigger mean stones size (p-value=0.008) and are at higher risk of stone recurrence at 1 year (p-value =0.04) than non-diabetics. Stone recurrence was not significant at 3 and 5 years between the two groups. Diabetics significantly had higher urinary oxalate, and nearly statistically significant lower phosphate levels (p-value=0.007, 0.076 respectively).


Conclusions
Diabetics were significantly older and associated with metabolic syndrome. UTIs were more prevalent among diabetics which put them at risk of postoperative complications. Diabetics are at higher risk of stone recurrence at 1 year compare to non-diabetics. Biochemical urinary findings are important as they can guide the management of recurrent stone formers.

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