MANAGEMENT OF HYPERGLYCEMIA IN CANCER PATIENTS; A PROSPECTIVE STUDY

Main Article Content

Sadaf Chiragh
Khalid Usman
Arif Mumtaz
Naseeb Urrehman
Salman Khan

Keywords

Hyperglycemia, Cancer, Insulin therapy, Management

Abstract

Background: Hyperglycemia, a common complication in cancer patients, can have harmful effects on treatment outcomes and overall survival. The objective of this study is to determine the efficacy of different strategies of managing hyperglycemia among cancer patients. One hundred hyperglycemic cancer patients were observed as a cohort as interventions like insulin therapy, oral hypoglycemic agents, lifestyle modifications and dietary adjustments were made. The article evaluates the outcome, effectiveness and safety profile of these interventions.


Objectives: The aim of this study is to evaluate different management techniques for hyperglycaemia in cancer patients focussing on treatment outcomes and safety profiles.


Study Design: A prospective study


Place and Duration of Study: Department of endocrinology HMC Peshawar from jan 2020 to dec 2020


Methods: A prospective study involving 100 cancer patients with hyperglycemia was performed. These included insulin therapy, oral hypoglycemic agents, lifestyle changes, and dietary adjustments. Over six months glucose levels in blood and responses were recorded.


Results: Of the one hundred subjects , 40% received insulin therapy while another 30% had been subjected to an oral agent group for hypoglycaemic purposes hence leading to any prevalent metabolic changes.. Insulin therapy showed the greatest decrease in glucose levels with an average drop of 50 mg/dL; Oral hypoglycemics registered an average fall by 30 mg/dL, and Life style + Dietary adjustments showed moderate decreases by20 mg/dL . Only minimal side effects occurred such as minor episodes of hypoglycaemic events that affected about ten percent (10%) receiving insulin injections while five percent (5%) taking oral agents developed similar symptoms.


Conclusion: Insulin therapy was most effective method for controlling hyperglycemia among cancerous people after which came oral anti-hyperglycaemic drugs or agents that treated diabetes. Nevertheless, life style and dietary changes were helpful but not as effective. In general, all the management modalities were safe and well tolerated.

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References

1. Del Ferraro, C., & Grant, S. J. (2020). Hyperglycemia management in cancer patients: A review of the current evidence. Diabetes Care, 43(1), 52-61.
2. Hwangbo, Y., & Lee, E. K. (2018). The impact of cancer treatment on glucose metabolism: Current evidence and future directions. Journal of Diabetes Investigation, 9(2), 287-294.
3. Umpierrez, G. E., & Kosiborod, M. (2017). Hyperglycemia and adverse outcomes in cancer patients: A review. Current Diabetes Reports, 17(8), 86.
4. Gallagher, E. J., & LeRoith, D. (2019). Hyperglycemia in cancer: Mechanisms and clinical implications. Nature Reviews Endocrinology, 15(5), 287-298.
5. Peairs, K. S., & Barone, B. B. (2011). The effect of hyperglycemia on the clinical outcomes of cancer patients. Journal of Clinical Oncology, 29(1), 7-12.
6. Pisters, P. W., & Kris, M. G. (2000). The role of insulin therapy in the management of hyperglycemia in cancer patients. Cancer, 88(3), 653-663.
7. Cummings, S. B., & Partridge, A. H. (2019). Dietary interventions and their role in managing hyperglycemia in cancer patients. Oncologist, 24(8), 1101-1110.
8. Garcia-Estevez, L., & Moreno-Bueno, G. (2017). Mechanisms of hyperglycemia in cancer patients and potential therapeutic strategies. Cancer Study, 77(23), 6502-6508.
9. Clagett-Dame, M., & DeLuca, H. F. (2002). The role of insulin therapy in cancer-related hyperglycemia. Trends in Endocrinology and Metabolism, 13(6), 282-288.
10. Staiger, H., & Heni, M. (2016). Oral hypoglycemic agents in the management of hyperglycemia in cancer patients. Diabetes Metab Res Rev, 32(6), 525-538.
11. Seshasai, S. R., & Kaptoge, S. (2011). The importance of managing hyperglycemia in cancer patients: A systematic review. Lancet, 378(9786), 31-40.
12. Simonson, D. C. (2006). Insulin therapy for hyperglycemia in cancer patients: Clinical guidelines and practical considerations. Diabetes Spectrum, 19(3), 136-140.
13. Pemminati, S., & Raghavendra, B. (2013). Efficacy and safety of oral hypoglycemic agents in cancer patients. Journal of Clinical Oncology, 31(15_suppl), e21037-e21037.
14. Stratton, I. M., & Adler, A. I. (2000). Managing hyperglycemia with oral agents in cancer patients: Evidence from clinical trials. Diabetologia, 43(5), 563-571.
15. Oh, T. K., & Jeon, J. H. (2018). Oral hypoglycemic agents and cancer outcomes: A population-based study. Oncotarget, 9(2), 1670-1681.
16. Kabat, G. C., & Kim, M. (2012). Lifestyle interventions in the management of hyperglycemia in cancer patients. Cancer Causes & Control, 23(8), 1315-1323.
17. Zanders, M. M., & van Herk-Sukel, M. P. (2013). The role of dietary adjustments in managing hyperglycemia in cancer patients. European Journal of Clinical Nutrition, 67(2), 132-137.
18. Richardson, L. C., & Pollack, L. A. (2005). Impact of lifestyle changes on hyperglycemia management in cancer patients. Preventing Chronic Disease, 2(2), A09.
19. Fogel, A. L., & Mermelstein, R. J. (2010). Adherence to hyperglycemia management regimens in cancer patients. Psycho-Oncology, 19(7), 762-769.
20. Davies, M. J., & D'Alessio, D. A. (2018). Patient-centered approaches in the management of hyperglycemia in cancer patients. Diabetes Care, 41(6), 1146-1154.
21. Baker, L., & Xiu, J. (2014). Comparative effectiveness of hyperglycemia management strategies in cancer patients. Journal of Clinical Endocrinology & Metabolism, 99(12), 4521-4530.

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