INTRODUCTION: The aim of this study was to determine the impact of diabetes and antidiabetic medications on referral and pathological outcomes in uro-oncology cases. We report preliminary results from a single-center study. METHODS: We retrospectively collected data from 781 patients treated between 2018 and 2023 for radical prostatectomy (RP) for prostate cancer (PCa), radical cystectomy (RC) for bladder cancer, radical nephroureterectomy for upper tract urothelial carcinoma, partial nephrectomy and radical nephrectomy (RN) for renal cell carcinoma (RCC). A total of 617 (79%) patients were nondiabetics, and 164 (21%) were diabetics. Patient data were assessed for differences between diabetics and nondiabetics. RESULTS: All diabetic patients had a significantly higher BMI than nondiabetic patients (p <
0.05 for PCa and p = 0.006 for RC, respectively). In diabetic patients with PCa, a lower proportion of ISUP grade 3 and 5 PCa was seen (p = 0.047). In diabetic RCC patients on antidiabetic medication, there was a significantly higher incidence of recurrence rates after RN (p = 0.015). Penile cancer was diagnosed in diabetic patients at an older age (p = 0.019). CONCLUSION: Significantly, higher BMI was observed for RP and RC in diabetic patients, as well as for RCC after RN. Diabetics showed a significantly higher occurrence of recurrence for RCC after RN.