Glucocorticoid-induced diabetes mellitus in patients with lymphoma treated with CHOP chemotherapy

Lee, Sukyoung; Naoki, Katsuhiko; Yokoyama, Yasuhisa; Seki, Masanori; Hasegawa, Yoshinori; Okoshi, Yasushi

doi:10.1007/s00520-013-2097-8

Cited by 33 publications

(34 citation statements)

References 35 publications

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“…In a cohort of 90 patients with lymphoma or brain tumours treated with prednisone (in a regime also containing doxorubicin–cyclophosphamide–vincristine±rituximab), 58.9% developed hyperglycaemia and 13.3% diabetes ( Harris et al , 2013 ) ( Supplementary Table S3 ). In another cohort of 80 lymphoma patients treated with high doses of prednisone (in a regime with cyclophosphamide–hydroxydaunorubicin–oncovin), 32.5% patients developed diabetes mellitus ( Lee et al , 2014 ).…”

Section: Antineoplastic Therapies and Diabetesmentioning

confidence: 99%

From obesity to diabetes and cancer: epidemiological links and role of therapies

et al. 2016

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Increasing evidence suggests a complex relationship between obesity, diabetes and cancer. Here we review the evidence for the association between obesity and diabetes and a wide range of cancer types. In many cases the evidence for a positive association is strong, but for other cancer types a more complex picture emerges with some site-specific cancers associated with obesity but not to diabetes, and some associated with type I but not type II diabetes. The evidence therefore suggests the existence of cumulative common and differential mechanisms influencing the relationship between these diseases. Importantly, we highlight the influence of antidiabetics on cancer and antineoplastic agents on diabetes and in particular that antineoplastic targeting of insulin/IGF-1 signalling induces hyperglycaemia that often evolves to overt diabetes. Overall, a coincidence of diabetes and cancer worsens outcome and increases mortality. Future epidemiology should consider dose and time of exposure to both disease and treatment, and should classify cancers by their molecular signatures. Well-controlled studies on the development of diabetes upon cancer treatment are necessary and should identify the underlying mechanisms responsible for these reciprocal interactions. Given the global epidemic of diabetes, preventing both cancer occurrence in diabetics and the onset of diabetes in cancer patients will translate into a substantial socioeconomic benefit.

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Section: Antineoplastic Therapies and Diabetesmentioning

confidence: 99%

From obesity to diabetes and cancer: epidemiological links and role of therapies

et al. 2016

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“…Chemotherapy treatment may cause diabetes to develop earlier in susceptible women. Weight gain, estrogen suppression, and glucocorticoids are risk factors [11161718]. …”

Section: Hyperglycemia In Cancer Patientsmentioning

confidence: 99%

Acute Hyperglycemia Associated with Anti-Cancer Medication

Hwangbo

Lee

2017

Endocrinol Metab

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Hyperglycemia during chemotherapy occurs in approximately 10% to 30% of patients. Glucocorticoids and L-asparaginase are well known to cause acute hyperglycemia during chemotherapy. Long-term hyperglycemia is also frequently observed, especially in patients with hematologic malignancies treated with L-asparaginase-based regimens and total body irradiation. Glucocorticoid-induced hyperglycemia often develops because of increased insulin resistance, diminished insulin secretion, and exaggerated hepatic glucose output. Screening strategies for this condition include random glucose testing, hemoglobin A1c testing, oral glucose loading, and fasting plasma glucose screens. The management of hyperglycemia starts with insulin or sulfonylurea, depending on the type, dose, and delivery of the glucocorticoid formulation. Mammalian target of rapamycin (mTOR) inhibitors are associated with a high incidence of hyperglycemia, ranging from 13% to 50%. Immunotherapy, such as anti-programmed death 1 (PD-1) antibody treatment, induces hyperglycemia with a prevalence of 0.1%. The proposed mechanism of immunotherapy-induced hyperglycemia is an autoimmune process (insulitis). Withdrawal of the PD-1 inhibitor is the primary treatment for severe hyperglycemia. The efficacy of glucocorticoid therapy is not fully established and the decision to resume PD-1 inhibitor therapy depends on the severity of the hyperglycemia. Diabetic patients should achieve optimized glycemic control before initiating treatment, and glucose levels should be monitored periodically in patients initiating mTOR inhibitor or PD-1 inhibitor therapy. With regard to hyperglycemia caused by anti-cancer therapy, frequent monitoring and proper management are important for promoting the efficacy of anti-cancer therapy and improving patients' quality of life.

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“…Dexamethasone (8-12 mg) is used in the management of nausea and vomiting (Trigg & Higa, 2010), a common adverse effect of many cancer treatments. Various doses of dexamethasone (4-16 mg per day or more) have been used to control edema associated with brain metastasis (Ryken et al, 2010) Prednisone (100 mg) and dexamethasone (40 mg) have been used in combination with other chemotherapeutic agents as part of chemotherapy protocols (Lee et al, 2014;Romaguera et al, 2005). Methylprednisolone doses as high as 2 mg/kg per day have been used in the treatment of graft-versus-host disease (Holtan, Pasquini, & Weisdorf, 2014;Ruutu et al, 2014).…”

Section: Steroid-induced Hyperglycemiamentioning

confidence: 99%

Management of Steroid-Induced Hyperglycemia in Hospitalized Patients With Cancer: A Review

Brady¹,

Grimes²,

Armstrong³

et al. 2014

Oncology Nursing Forum

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Glucocorticoid-induced diabetes mellitus in patients with lymphoma treated with CHOP chemotherapy

Abstract: The results suggest a guideline for plasma glucose monitoring during CHOP chemotherapy in patients with no history of DM.

Cited by 33 publications

References 35 publications

From obesity to diabetes and cancer: epidemiological links and role of therapies

From obesity to diabetes and cancer: epidemiological links and role of therapies

Acute Hyperglycemia Associated with Anti-Cancer Medication

Management of Steroid-Induced Hyperglycemia in Hospitalized Patients With Cancer: A Review

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