From the Research
Effects of Lupron (Leuprolide) on Hemoglobin A1C (HbA1C) Levels
- The study published in 2005 1 reported two cases of patients who developed marked hyperglycemia after androgen-deprivation therapy for prostate cancer, with significant increases in fasting glucose and HbA1c levels after leuprolide acetate treatment.
- In one case, a 61-year-old man with type 2 diabetes mellitus had good glycemic control for 5 years, but after the second injection of leuprolide acetate, his fasting glucose and HbA1c levels increased to 22.8 mmol/L and 10.5%, respectively.
- In the other case, an 81-year-old man with normal fasting glucose and HbA1c levels 10 months prior developed diabetes mellitus with a fasting glucose of 19.4 mmol/L and HbA1c of 9.9% after 6 months of leuprolide treatment.
- The study suggests that insulin resistance after androgen-deprivation therapy might lead to marked hyperglycemia in these patients.
- However, other studies, such as the one published in 2020 2, found no significant differences in changes in HbA1c levels between patients treated with leuprolide and those treated with degarelix, another gonadotropin-releasing hormone agonist.
- The study published in 2023 3 focused on the effects of leuprolide on abdominal adiposity and cardiac function in middle-aged male mice, but did not report any changes in HbA1c levels.
Mechanism of Action
- Leuprolide is a gonadotropin-releasing hormone agonist that acts on the anterior pituitary to induce a transient early rise in gonadotropin release, followed by pituitary desensitization and/or down-regulation, leading to suppressed circulating levels of gonadotropins and sex hormones 4, 5.
- This mechanism of action may contribute to the development of insulin resistance and hyperglycemia in some patients, as reported in the 2005 study 1.