Diabetologists and Oncologists attitudes towards treating diabetes in the oncologic patient: Insights from an exploratory survey

Clemente, Gennaro; Giorgini, Marisa; Mancini, Marcello; Gallo, Marco

doi:10.1016/j.diabres.2018.02.044

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…Despite the observed frequency of diabetes and oncology, limited guidelines and protocols exist to guide and inform care delivery processes and treatment regimens for this patient population. 53 - 56 This is further coupled with confusion over the roles and responsibilities of oncology and diabetes/endocrinology HCPs, an overall lack of knowledge surrounding which condition is the pathological source of the symptom(s) and/or presenting complication(s), and the uncoordinated and/or conflicting manner and practices of oncology and diabetes/endocrinology HCPs. 46 , 54 The findings from this meta-analysis highlight a challenging health care period for this unique patient population and have 2 significant implications for the concurrent burden and impact of cancer and DM on patients and the health care system.…”

Section: Discussionmentioning

confidence: 99%

“…The first implication is the need for optimal concurrent management of both diseases and overcoming the compartmentalization of medicine and specializations through better interdisciplinary collaboration among oncology and endocrinology HCPs/teams to achieve a shared approach and standard in the level of care afforded to this patient population. 53 - 55 , 57 A practical solution to these complex issues and addressing and/or mitigating such complications is through the development of integrated, shared, and coordinated clinical care pathways between oncology and diabetes HCPs/teams that place the patient at the center of the care process. 54 , 55 , 57 Integrated, shared, and coordinated clinical care pathways are novel approaches that hold great potential in overcoming the health disparities in this patient population by (a) increasing communication and coordination between oncology and endocrinology HCPs/teams, (b) taking all diabetes and oncology-related treatment options into consideration and developing tailored treatment plans for patients, (c) sharing evidence-based clinical resources and tools, and (d) educating care teams and patients on the dual disease management by understanding how these diseases interact, the importance of diabetes self-management, and the ability to recognize and address common adverse outcomes/complications.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Diabetes Mellitus on Oncological Outcomes for Patients Living With Cancer

Murphy

Sherifali

Ali

et al. 2023

The Science of Diabetes Self-Management and Care

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Purpose The purpose of this meta-analysis was to examine the association between preexisting diabetes in persons living with cancer on diabetes and oncology-related health outcomes. Understanding this association is of priority because the incidence of both cancer and diabetes mellitus is increasing worldwide. Methods A comprehensive review of the literature was conducted in collaboration with an expert health sciences librarian. Two authors independently conducted the screening, data collection, and extraction processes. The risk of bias was assessed using several tools, depending on the study design. Relative risks with 95% confidence intervals were calculated. The alpha threshold was 0.05. All analyses were performed using R statistical software (Metaphor and Demeter packages). Results A total of 45 studies met the selection criteria, but 23 were excluded from the synthesis because they did not have the ranked outcome or correct comparison (persons with and without diabetes), totaling 22 studies included in the meta-analysis. In comparison to participants without preexisting diabetes, participants with preexisting diabetes and cancer were found to have a significantly higher risk of infection and cardiovascular, neurological, gastrointestinal, hepatic, and renal complications. Concurrent preexisting diabetes and cancer were also associated with increased health care service utilization and length of hospital stay. Conclusion The findings from this review highlight the importance of optimal concurrent management of both diseases by overcoming the compartmentalization of medical specializations through (1) integrated, multidisciplinary, shared, and coordinated clinical care pathways between oncology and diabetes health care providers/teams and (2) the continued development of evidence-based clinical guidelines.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Influence of Diabetes Mellitus on Oncological Outcomes for Patients Living With Cancer

Murphy

Sherifali

Ali

et al. 2023

The Science of Diabetes Self-Management and Care

View full text Add to dashboard Cite

show abstract

“…Between October 2014 and April 2015, the working group promoted and carried out a survey that involved 252 Italian physicians (diabetologists, oncologists, and palliativists). This survey provided interesting data about the critical care issues in managing cancer patients with alterations to their glucose metabolism [19]. For example, it found that:…”

Section: Introductionmentioning

confidence: 99%

An integrated care pathway for cancer patients with diabetes: A proposal from the Italian experience

Gallo

Clemente

Corsi

et al. 2020

Diabetes Research and Clinical Practice

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“…Indeed, there is a lack of relevant evidence particularly from randomised clinical trials that guides DM management in the context of palliative care. Even the opinions of diabetologists and oncologists were different dealing with diabetes care in people with cancer 14. To the best of our knowledge, the most resourceful nutritional approach, oral and injectable (non-insulin) agents, types of insulin or insulin regimens, are still unknown to manage DM in the palliative context.…”

Section: Introductionmentioning

confidence: 99%

Diabetes-related symptoms, acute complications and management of diabetes mellitus of patients who are receiving palliative care: a protocol for a systematic review

et al. 2019

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IntroductionWorldwide, an estimated 40 million people are in need of palliative care each year, but only 14% receive it. The incidence of diabetes mellitus (DM) in patients receiving palliative care is higher than in the general population. This association is intended to grow as a result of the rising burden of DM worldwide, ageing populations and the improved overall survival time of several diseases over the last few decades. Recommendations for DM management in the context of palliative care are mainly based on expert opinion as there is a lack of suitable evidence base and randomised clinical trials in palliative care are scarce. The aim of our systematic review is to identify the best DM management practices in order to reduce important DM-related symptoms and acute complications in patients receiving palliative care.Methods and analysisThe authors will study the DM treatment and management literature, surveying the different approaches employed to treat adult palliative patients. Core health bibliographic databases will be searched from January 1990 to May 2019. Data sources will include Ovid MEDLINE, Embase, PubMed, Web of Sciences, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, Cumulative Index to Nursing and Allied Health Literature and grey literature. Details regarding diet, oral and injectable glucose-lowering medicines, insulin regimens and blood glucose monitoring strategies will be evaluated. We defined the primary outcomes to compare between DM management approaches as the presence of symptoms (polyuria, polydipsia and polyphagia) and acute complications of DM (hypoglycaemia, hyperglycaemic hyperosmolar state and diabetic ketoacidosis), and secondary outcomes as hospital admissions and deaths due to DM-related complications, health-related quality of life and glycaemic control.Ethics and disseminationThe systematic review methodology does not require ethics approval due to the nature of the study design. The results of the systematic review will be published in a peer-reviewed journal and will be publicly available.PROSPERO registration numberCRD42018115772.

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Diabetologists and Oncologists attitudes towards treating diabetes in the oncologic patient: Insights from an exploratory survey

Cited by 7 publications

References 13 publications

Influence of Diabetes Mellitus on Oncological Outcomes for Patients Living With Cancer

Influence of Diabetes Mellitus on Oncological Outcomes for Patients Living With Cancer

An integrated care pathway for cancer patients with diabetes: A proposal from the Italian experience

Diabetes-related symptoms, acute complications and management of diabetes mellitus of patients who are receiving palliative care: a protocol for a systematic review

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