Glucocorticoid-Induced Hyperglycemia Is Prevalent and Unpredictable for Patients Undergoing Cancer Therapy: An Observational Cohort Study

Abstract

ConclusionsGlucocorticoid-induced hyperglycemia is common in patients undergoing cancer treatment and cannot be predicted by traditional risk factors for dm. We recommend that all cancer patients receiving gc be screened for hyperglycemia at least 4-6 hours after gc administration.

Assessing the prevalence of dexamethasone use in patients undergoing surgery, and subsequent glucose measurements: a retrospective cohort study

“…While we did not set out to look for differences in outcomes between those who were given dexamethasone and those who were not, previous work has shown that glucocorticoid administration is associated with hyperglycaemia . Further, there have been several studies showing that hyperglycaemia in the postoperative period is associated with harm.…”

Measurement of Hyperglycemia and Impact on Health Outcomes in People With Cancer: Challenges and Opportunities

“…Frequent monitoring for glucocorticoid induced hyperglycemia is recommended. FBG may not adequately reflect the influence of glucocorticoids, as post prandial (2 hours post meal) or random blood glucose (4-6 hours after receipt of glucocorticosteroids) best capture their effects on blood glucose (Gallo et al, 2016; Harris et al, 2013). In the studies reviewed, the type of glucose measurement reported may have been influenced by known diabetes status and/or practitioner preference.…”

“…Harmful consequences from hyperglycemia have also been noted among patients with cancer (Storey & Von Ah, 2012; Storey & Von Ah, 2015). In pre-clinical and clinical studies, the presence of hyperglycemia has been shown to increase the risk of development and progression of cancer, impact diagnostic imaging studies, attenuate the immune system and increase resistance to chemotherapy (Adham et al, 2014; Biernacka et al, 2013; Germenis & Karanikas, 2007; Harris et al, 2013; Kellenberger et al, 2010; Rabkin, Israel, & Keidar, 2010). However, researchers have found discordant findings as it relates to the impact of hyperglycemia on the health-related outcomes including infection, toxicity, morbidity and/or mortality (Olausson, Hammer, & Brady, 2014; Storey & Von Ah, 2012).…”

“…However, people with cancer experience unique challenges to glycemic homeostasis as a consequence of cancer and its treatment (Hammer et al, 2016). Factors contributing to hyperglycemia in people with cancer include: physiologic stress, glycemic status (glucose intolerant, diagnosis of diabetes, pre or unknown diagnosis of diabetes), the administration of glucocorticoids, and changes in nutrition and activity (Dungan, Braithwaite, & Preiser, 2009; Harris et al, 2013; Hershey et al, 2014). An additional challenge is the receipt of frequent blood transfusions to address disease/treatment related anemia which precludes the use of Hemoglobin A 1c (HbA1 c ), the blood test recommended for diagnosing diabetes and monitoring blood glucose (Farrokhi, Smiley & Umpierrez, 2011) (Shrot, Patel, & Foulis, 2007).…”

Rouleaux formation of white blood cells and platelets in leukemia

“…A modest level of hyperglycemia in leukemia causes hospital mortality (ALI et al, 2007, ALI et al, 2006, it may also occur during leukemia therapy and may be fatal (WANG et al, 1993, ALI et al, 2006. So it is necessary to control blood glucose level during treatment (PUI et al, 1981, HARRIS et al, 2013.…”