Challenges in the management of people with diabetes and cancer

Diabet Med. 2019 Jul;36(7):795-802. doi: 10.1111/dme.13919. Epub 2019 Feb 16.

Abstract

Although micro- and macrovascular complications of diabetes are the most important cause of mortality and morbidity in people with diabetes, it is increasingly recognized that diabetes increases the risk of developing cancer. Diabetes and cancer commonly co-exist, and outcomes in people with both conditions are poorer than in those who have cancer but no diabetes. There is no randomized trial evidence that treating hyperglycaemia in people with cancer improves outcomes, but therapeutic nihilism should be avoided, and a personalized approach to managing hyperglycaemia in people with cancer is needed. This review aims to outline the link between diabetes therapies and cancer, and discuss the reasons why glucose should be actively managed people with both. In addition, we discuss clinical challenges in the management of hyperglycaemia in cancer, specifically in relation to glucocorticoids, enteral feeding and end-of-life care.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Blood Glucose
  • Comorbidity
  • Enteral Nutrition
  • Glucocorticoids
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / chemically induced*
  • Neoplasms / drug therapy*
  • Neoplasms / metabolism
  • Practice Guidelines as Topic
  • Terminal Care / methods*

Substances

  • Antineoplastic Agents
  • Blood Glucose
  • Glucocorticoids