Type 2 Diabetes Mellitus and Glioblastoma Multiforme-Assessing Risk and Survival: Results of a Large Retrospective Study and Systematic Review of the Literature

World Neurosurg. 2017 Oct:106:300-307. doi: 10.1016/j.wneu.2017.06.164. Epub 2017 Jul 8.


Objective: Despite studies showing a positive correlation between type 2 diabetes mellitus (DM2), a modifiable risk factor, and various cancer types, the link remains controversial in the setting of glioblastoma multiforme (GBM). In this study, we assessed whether DM2 and DM2-associated factors were associated with a higher risk of developing GBM and also determined if DM2 affected the survival of patients with GBM.

Methods: A cross-sectional case-control study of 1144 GBM cases diagnosed between 2000 and 2013 of which 969 patients matched for age and sex was performed to assess the association between DM2, hyperlipidemia, and obesity with the incidence of GBM. A longitudinal study of the patients with GBM was also performed to assess the association between the effect of DM2 and GBM survival.

Results: No association was seen between DM2, hyperlipidemia, obesity, and GBM. DM2 was associated with poorer survival in univariate testing yet not in multivariate testing. Diabetic patients with GBM had good glycemic control. Older patients had poorer survival and overall survival improved over years of study.

Conclusions: DM2, hyperlipidemia, and obesity were not associated with increased risk of developing GBM, and DM2 itself does not seem to influence survival among these patients. This finding might be related to good glycemic control in this cohort. Survey of the literature consistently shows that hyperglycemia is associated with poorer survival. Our findings suggest that rather than the presence or absence of DM2, glycemic control seems to be more important in the survival of patients with GBM, which warrants future investigation.

Keywords: Diabetes mellitus; Glioblastoma multiforme; Hyperglycemia; Hyperlipidemia; Obesity; Risk; Survival.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Blood Glucose / metabolism
  • Brain Neoplasms / epidemiology*
  • Brain Neoplasms / mortality
  • California / epidemiology
  • Case-Control Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / metabolism
  • Female
  • Glioblastoma / epidemiology*
  • Glioblastoma / mortality
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hyperlipidemias / epidemiology*
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Obesity / epidemiology*
  • Registries*
  • Retrospective Studies
  • Risk Factors


  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human