Importance of glycemic control in cancer patients with diabetes: Treatment through end of life

Abstract

Cancer patients with diabetes are at increased risk for developing infections, being hospitalized, and requiring chemotherapy reductions or stoppages. While it has been hypothesized that glycemic control increases the risk for these adverse events, few studies have explored this hypothesis. The purpose of this paper is to discuss the importance of glycemic control in patients with diabetes and cancer during treatment through end of life. Glycemic control was found to play a role; the overall level of health-related quality of life experienced by patients with cancer and diabetes, level of symptom severity experienced and can impact the overall survival of the individual. Evidence-based policies and practice guidelines also need to be developed to help clinicians manage these patients during all phases of care. Using diabetes educators and advance practice, nurses to provide management and care coordination services need to be considered. Survivorship care plans should address both cancer and diabetes management. Finally, glycemic control should continue through end of life, with the main goal of avoiding hypoglycemic events.

Impact of clinical pharmacy recommendations and patient counselling program among patients with diabetes and cancer in outpatient oncology setting

“…Health‐care providers, including clinical pharmacists, should be aware of the possible simultaneous occurrence of DM and cancer, demanding complex management of the two chronic conditions with immense effect on the patient‐related outcomes (Hershey, 2017). As the role of clinical pharmacist has been changed from medication‐centred to a more personalised patient‐centred, the clinical pharmacist can play vital role in the care of diabetes and cancer by means of a variety of professional services (Steeb, Joyner, & Thakker, 2014).…”

Eliciting Provider Perspectives on Diabetes Management During Cancer Care

“…This model of care delivery poses challenges for comorbidity management because PCPs are left out of making critical decisions pertaining to diabetes management during cancer care. As studies have shown that cancer patients with concurrent diabetes report worse health-related outcomes and health-related quality of life than those without diabetes, 17,32 actively engaging general practitioners into the oncology-based care team may help to improve glycemic control in cancer patients with diabetes. A multi-disciplinary care team that incorporates frequent communication and coordination between oncologists and PCPs of the patient's care team is needed to improve healthoutcomes for this patient group.…”

Chemo‐mechanistic multi‐scale model of a three‐dimensional tumor microenvironment to quantify the chemotherapy response of cancer

“…In addition to the therapeutic problems caused by heterogeneity and abnormality of TME, cancer patients are faced with systematic abnormalities arising from either cancer‐induced metabolism impairments or chemotherapy‐induced disorders (Hershey, 2017; Jacob & Chowdhury, 2015). Hyperglycemia as the main feature of diabetes is the most common disorder for cancer patients.…”

“…Hyperglycemia as the main feature of diabetes is the most common disorder for cancer patients. Clinical studies show that the probability of diabetes increases up to 30% in cancer patients that gets even worse during chemotherapy (Hershey, 2017). On the other hand, diabetes (primarily type 2) is associated with increased risk of some cancers including liver, pancreas, endometrium, colon and rectum, breast, and bladder (Giovannucci et al, 2010).…”

“…On the other hand, diabetes (primarily type 2) is associated with increased risk of some cancers including liver, pancreas, endometrium, colon and rectum, breast, and bladder (Giovannucci et al, 2010). Some clinical studies have shown that glycometabolism disorders induced by chemotherapy cause blood glucose significantly high or even diabetes mellitus (Ahn et al, 2020; Hershey, 2017). Hyperglycemia through which glucose‐hungry cancer cells are fed with an excess amount of glucose contributes to oncogenesis, chemoresistance, and apoptosis resistance (Duan et al, 2014).…”