Associations between Diabetes and Quality of Life among Breast Cancer Survivors

Abstract

ObjectiveWe aimed to investigate the associations between diabetes and quality of life (QOL) among breast cancer survivors.MethodsA cross-sectional survey was conducted at 34 Cancer Recovery Clubs across China from May 2014 to January 2015. Quality of life was measured by the Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the Quality of Life Questionnaire-Breast Cancer Module 23 (QLQ-BR23, simplified Chinese version). Information on social-demography, diagnosis and treatment of tumors, and diabetes mellitus were collected by self-reported questionnaires. Univariate analyses of covariance (ANCOVA) was performed to assess the difference in QOL between patients with or without diabetes mellitus, and multiple linear regression models were used to examine the associations after controlling for confounders.ResultsDiabetes, both of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) significantly reduced QOL. This effect of diabetes on QOL is independent of tumor size, regional lymph node metastasis, distant metastasis and tumor stage index (TNM). After adjusting for different social-demography, diagnosis and treatment of the tumor, the tumor’s stage and other chronic comorbidities, breast cancer survivors with diabetes got significantly lower scores in functional dimensions (including physical, role, emotional and social functionings measured by EORTC QLQ-C30; body image (BRBI) and future perspective (BRFU) measured by QLQ-BR23, as well as economic difficulties than those without diabetes (Padjusted<0.05). Diabetic patients also obtained higher scores in symptom dimensions, including fatigue, nausea and vomiting, pain, dyspnoea, insomnia, constipation and diarrhoea measured by EORTC QLQ-C30; side effects, breast symptoms and upset by hair loss measured by QLQ-BR23 (Padjusted<0.05). Compared to patients with T1DM, those with T2DM are likely to suffer more by loss of functioning.ConclusionsDiabetes was associated with the decreased QOL for breast cancer survivors.

<p>Quality of life of women with breast cancer undergoing treatment and follow-up at King Salman Armed Forces Hospital in Tabuk, Saudi Arabia</p>

“…Studies have shown a negative age effect and a positive effect of education on QOL 4,7. Previous studies have reported that patients with multiple tumors and metastasis tend to have poor QOL 7,14,15. The same trend regarding multiple tumors and metastatic disease was observed in this study.…”

The predictors of poor quality of life in a sample of Saudi women with breast cancer

“…We noted that breast cancer patients who reported having metastasis and multiple tumors have pain, very poor physical functions, role limitations due to emotional problems, little vitality, low social functioning, and poor general health. Metastasis 46 , 47 and multiple tumors 48 have been linked with poor QoL in previous studies. According to our study, fever indicates considerable deterioration in the breast cancer patient’s QoL.…”

Glucose insult elicits hyperactivation of cancer stem cells through miR-424–cdc42–prdm14 signalling axis

“…Diabetes mellitus not only worsens the prognosis ( Kaplan et al , 2012 ; Villarreal-Garza et al , 2012 ; Yerrabothala et al , 2014 ) but also the quality of life of breast cancer patients ( Tang et al , 2016 ). Diabetes being a metabolic disorder can affect cancer progression and recurrence through factors such as hyperglycaemia ( Villarreal-Garza et al , 2012 ; Flores-Lopez et al , 2016 ), hyperinsulinaemia ( Flores-Lopez et al , 2016 ) and hyperlipidaemia ( Owiredu et al , 2009 ; Emaus et al , 2010 ; Kaye et al , 2002 ).…”