Shock wave lithotripsy and diabetes mellitus: A population-based cohort study

Objective: To determine if shock wave lithotripsy (SWL) is associated with diabetes mellitus (DM) in a community setting. The pancreas is vulnerable to injury at SWL as evidenced by case studies; thus, concern exists for the development of DM after SWL. Methods: The Rochester Epidemiologic Project was used to identify all Olmsted County, Minnesota residents diagnosed with urolithiasis from 1985 to 2008. New-onset DM was identified by diagnostic codes and treatment with SWL by surgical codes. Cox proportional hazards models were used to determine the risk of DM after SWL therapy. Results: A total of 5287 incident cases of stone formation without pre-existing DM and with <3 months of follow-up. After an average follow-up of 8.7 years, 423 patients (8%) were treated with SWL and new-onset DM had developed in 743 (12%). The diagnosis of DM followed SWL in 77 patients. However, no association was evident between SWL and the development of DM before (hazard ratio 0.98, 95% confidence interval 0.76-1.26) or after (hazard ratio 0.92, 95% confidence interval 0.71-1.18) SWL, controlling for age, sex, and obesity. Conclusion: In the present large, population-based cohort, the long-term risk of developing DM was not increased in persons who underwent SWL to treat their kidney stones.