ADT and A1c

[podsart]

Does ADT, in my case relugolix, and/or daralutamide tend to raise A1c levels?

[PCaWarrior]

ADT does. Darolutamide does but to a lesser extent.

Talk to your MO. How high is your A1c? Frequently they will use Metformin if it gets too high.

[podsart in reply to PCaWarrior]

Thanks

A1c has been moving up: 5.4, 5.5, 5.6, and just yesterday 5.7

Dr Myers put me on max dose metformin 1000mg x 2 per day years ago as he felt it had anti Pca power to some extent

[PCaWarrior in reply to podsart]

It could have some therapeutic affect. Studies are mixed. But it should help A1c. If anti PCa. Bonus.

[Murk in reply to podsart]

Yup, my A1C rose very similar to what you are seeing when I was taking Orgovyx.

[fast_eddie in reply to podsart]

My A1c has been higher than that -- flirting with type 2 diabetes. I am on metformin 500 mg 3x a day. I believe that it as anti-PC benefit. I have only my wanton snacking to blame for my high A1c. I am working to reduce sugary snack intake.

[stealthrider]

21 months in on Eligard, my A1C is rising, most recently 6

[6357axbz]

My A1C has been at 6 for a long time. I’ve been on 1000 mg metformin for years and on Jardiance for over a year.

[podsart]

thanks all

jardiance I guess is a possible add on

[Shellhale in reply to podsart]

Maybe add berberine.

[podsart in reply to Shellhale]

interesting, can u pls provide links for berberine , especially clinical articles?

[Professorgary in reply to podsart]

There are numerous articles on berberine for glucose levels. I am very computer illiterate so Ibreally don’t know how to post links but you can find them by googling berberine and insulin resistance. Berberine also has some suppression effect on acr1c3 expression. It has a positive effect on gut health as well. My non fasting glucose level dropped from 120 to 140 to mid 90s the last two tests.

[Shellhale in reply to Shellhale]

pmc.ncbi.nlm.nih.gov/articl... My husband's A1C was 5.9 and now 5.4 but he also uses Metformin. I use it also. It activates AMPK

pubmed.ncbi.nlm.nih.gov/168...

[Conlig1940 in reply to Shellhale]

Shellhale : I am pre diabetic and a PC suffer , my PSA is 19.2 , my Lab PSA is 9.6 but I have to double it due to my Dutasterude medication for BPH . I inquired if Metformin would help my condition . I was advised there is no conclusive evidence that Metformin helps PC .

Your thoughts would be appreciated .

[Shellhale in reply to Conlig1940]

I've seen mixed reviews. The most recent study that I am aware of was done with gleason 6 PCa with a higher BMI and it was shown that it didn't make any significant improvements. But I believe it does just from what I've seen ancedotally. With a Gleason 9 and my husband's aggressive mutations we are going to take our chances and inhibit every pathway we can. Maybe we will alternative between berberine and metformin later. So far his PCa is not behaving aggressively. Do you think Metformin will help with your pre-diabetic status?

[Conlig1940 in reply to Shellhale]

Shellhale . I am a patient at Princess Margaret Hospital in Toronto . My curiousity was prompted by an interview by Dr. Rashid Sayyid with Dr. Neil Fleshner , both from PMH , regarding the MASK TRIAL .

[fast_eddie in reply to Conlig1940]

Metformin is inexpensive and safe. Since you are pre-diabetic, it is a no-brainer. If your doctor won't prescribe it, find a new doctor. BTW, after I read that metformin could have a benefit for PC I asked my doctor to prescribe it and to refill a lorazepam prescription for occasional insomnia. He refused both. And I was pre-diabetic at the time. He was a real dick. His ego wouldn't allow a patient to boss him around. He left the practice. I got a new doctor, a lady. I asked for those prescriptions -- no problem.

[Conlig1940 in reply to fast_eddie]

fast-eddie What year did you have HIFU ?

[Bill6033]

I was on Orgovyx for 24 months. My A1C went from 5.4 to 6 while taking 1,000 mg of metformin. Once I stopped Orgovyx my A1C dropped to 5.5 after about 9 months.

[podsart in reply to Bill6033]

Yea , if Relugolix does a good job for me and don’t want an injectable, I’m stuck an elevated A1c

Thanks

[T911]

My A1c went up to 6.0 on Orgovyx.

[vintage42]

My glucose was 115 and A1C was 5.6 before I started Orgovyx and Abiraterone + Prednisone. Six months later they were 124 and 6.0. At 12 months now, my MO has ordered another A1C test and may prescribe a med for it. He says the A1C rose because the steroid Prednisone raised the glucose level.

AI says "Prednisone is a corticosteroid medication that can increase insulin resistance and glucose production in the body. This can lead to higher blood sugar levels, known as hyperglycemia."

[podsart]

perversely, my lipid profile dropped during the same test periods. For example Total cholesterol: 159, 112, 99. Triglycerides: 101, 69, 56.

The other cholesterol components dropped similarly.

[AlvinSD]

Through my 30s and 40s, my A1c was always right around 4.9-5%. Very consistent for years until I started ADT and darolutamide. I’ve been on it for almost 3 years and it’s now up to 5.6% despite daily exercise.

[janebob99]

If you are concerned about glucose and a1c rise, you may want to switch to transdermal estradiol patches for ADT. In the PATCH phase-II head-to-head study versus Lupron, etc. ADT, estradiol patches had significantly lower glucose levels.

[podsart]

thanks will look into it

[Rcole727]

Ive been on ADT since October 2024- Firmagon and Nubeqa. My A1C rose to 6.9 from 5 with high Glucose leveland my PC prescribed Mounjaro. Since 2/14 when started Mounjaro glucose went down to normal levels per lab but A1C is slow to react down to 6.1 last lab a week ago. Lost 17 pounds too. Started 194 lb. now 177.

[CavScout]

I'm on Eligard and Zytiga. Both for about a year now. Within 3 months of starting ADT my fasting glucose went from an average of about 90-95 to 135-145. My A1C rose from 4.5 to 7.2. I am on metformin but it has had no impact on glucose and A1C. I did some reading on my own and it appears to be the case that when insulin sensitivity is degraded by metabolic syndrome metformin will be helpful. But in the case of ADT induced insulin insensitivity it may not help at all. In my case it hasn't.

Edit: My lipid profile is in line with index ranges

[TaylorMill]

Interesting thread. Thanks to all. I started taking a moderate dose of Metformin prior to start of four years of ADT ( (Lupron or Eligard ) along with bicalutamide). My A1C levels have warranted a gradual increase of dosage and now at max. It makes me wonder if any part of A1C increases of my own were at least in part related? I'm guessing perhaps minor --- at no time did my own MedOnc or Primary Care MD raise any discussion/question related to this issue --- I will probably enquire in more depth as my PC Doc anticipates sometime this year he will elevate my diabetes med to Jardiance or Ozempic