A recent Brady study has identified new risk factors for a major complication in patients who undergo surgery for bladder cancer. This investigation began with the sobering fact that often, bladder cancer is not the only significant illness. “Diabetes is a common problem in this patient population,” says urologic oncologist Nirmish Singla, M.D., M.Sc. Many of these individuals are also taking metformin, a diabetes-managing medication. 

In a recent study, Brady investigators analyzed a national database, TriNetX, for links between having diabetes, using metformin, and developing metabolic acidosis – a serious complication in which acid builds up in the body’s fluids. They examined the records of more than 13,000 patients who underwent surgical treatment for bladder cancer with a radical cystectomy and urinary diversion. 

“We found that diabetes significantly increases the risk of developing metabolic acidosis after undergoing radical cystectomy,” says Singla, who led the study, “especially in those who receive a continent diversion. Metformin use may also contribute to metabolic acidosis risk, but its impact may be less significant than that of diabetes itself.” 

For these patients, the study highlights the importance of “close management of comorbid conditions and careful attention to medications, in collaboration with a primary care or subspecialty provider,” Singla adds. “We hope our findings will lead to improved outcomes and a lower risk of side effects in these patients.” This work was published in Urologic Oncology: Seminars and Investigations.