From the Guidelines
Finasteride does not typically cause high blood sugar. Finasteride, which is commonly prescribed to treat male pattern baldness (at 1mg daily) and enlarged prostate (at 5mg daily), works by inhibiting the enzyme that converts testosterone to dihydrotestosterone (DHT). This mechanism of action does not directly affect glucose metabolism or insulin sensitivity.
Key Points to Consider
- Clinical studies and post-marketing surveillance have not established a significant association between finasteride use and elevated blood sugar levels 1.
- The most common side effects of finasteride include decreased libido, erectile dysfunction, decreased ejaculate volume, and in rare cases, breast tenderness or enlargement.
- If you're taking finasteride and experiencing high blood sugar, it's more likely due to other factors such as diet, lifestyle, other medications, or underlying health conditions.
- Anyone concerned about blood sugar levels while taking finasteride should consult their healthcare provider, as they can evaluate individual circumstances and determine if there might be an unusual reaction or if other factors are contributing to blood sugar changes.
Relevant Evidence
The provided evidence 1 does not suggest a link between finasteride and high blood sugar, and the most recent study 1 supports the idea that finasteride does not have a significant impact on glucose metabolism.
Conclusion Not Needed, Recommendation Only
Based on the most recent and highest quality study 1, finasteride is not likely to cause high blood sugar, and its use should not be a concern for patients in terms of glucose metabolism.
From the Research
Finasteride and High Blood Sugar
- There is limited direct evidence on the relationship between finasteride and high blood sugar, but some studies suggest that finasteride may be associated with an increased risk of metabolic dysfunctions, including insulin resistance and type 2 diabetes 2.
- A study found that finasteride users with type 2 diabetes mellitus did not have a significantly higher risk of poor glycemic control compared to tamsulosin users 3.
- Another study suggested that long-term use of finasteride may be associated with health risks, including non-alcoholic fatty liver disease, insulin resistance, and type 2 diabetes, due to the inhibition of 5α-reductases and the resulting decrease in 5α-dihydrotestosterone biosynthesis 2.
- However, the current evidence is not sufficient to establish a clear link between finasteride and high blood sugar, and more research is needed to fully understand the potential effects of finasteride on glucose homeostasis.
Potential Mechanisms
- The inhibition of 5α-reductases by finasteride may lead to a novel form of tissue-specific androgen deficiency, which could contribute to various pathophysiological conditions, including metabolic dysfunctions 2.
- The decrease in 5α-dihydrotestosterone biosynthesis may also affect the physiological function of various tissues, including the liver, pancreatic β-cells, and kidneys, potentially leading to metabolic abnormalities 2.
Study Limitations
- The available studies have limitations, including retrospective designs and potential confounding variables, which may affect the accuracy of the findings 3, 2.
- Further research is needed to confirm the potential association between finasteride and high blood sugar, and to fully understand the underlying mechanisms and potential risks associated with long-term finasteride use 3, 2.