Glycemic Status and Infection Risk in Nondiabetic Autologous Hematopoietic Cell Transplantation Recipients

Abstract

Understanding the contributors to and consequences of malglycemic events can lead to better protocols for identifying patients at greater risk for infection. Further investigation is warranted for interventions to mitigate BG events for improved outcomes.

Measurement of Hyperglycemia and Impact on Health Outcomes in People With Cancer: Challenges and Opportunities

“…The majority of the studies 17/30 (56%) used thresholds ranging between 99 mg/dL to < 126 mg/dL (Ali et al, 2007; Barba et al, 2012; Derr et al, 2009; Derr, Hsiao, & Sauder, 2008; Garg, Bhutani, Alyea, E. &Pendergrass, M., 2007; Flood et al, 2007; Fuji et al, 2007; Fuji et al, 2009; Gebremedhin, Behrendt, Nakamura, Parker, & Salehian, 2013; Hammer et al, 2016; Ito et al, 2014; Luo, Chen, & Chang, 2012; Matias et al, 2013; Storey & Von Ah, 2015; Storey & Von Ah, 2016; Tieu et al, 2015; Wright et al, 2013). …”

“…While the majority of the studies (40%) used FBG a variety of testing types were used in the studies (Barba et al, 2012; Flood et al, 2007; Fuji et al, 2007; Gebremedhin et al, 2013; Hammer et al, 2016; J. Luo et al, 2012; Matias et al, 2013; Sheean, Freels, Helton, & Braunschweig, 2006; Sheean et al, 2013; Storey & Von Ah, 2015; Storey & Von Ah, 2016; Villarreal-Garza et al, 2012).…”

“…Thirteen studies (43%) examined the timing of hyperglycemia at different intervals throughout the trajectory of cancer and cancer treatment (Barba et al, 2012; Brunello et al, 2010; Derr et al, 2008; Flood et al, 2007; Fuji et al, 2007; Hammer et al, 2009; Hammer et al, 2016; Ito et al, 2014; Jackson, Amdur, White, & Macsata, 2012; Matias et al, 2013; Storey & Von Ah, 2015; Storey & Von Ah, 2016; Wright et al, 2013). Two studies examined the impact of hyperglycemia at the time of diagnosis on disease progression and/or recurrence (Barba et al, 2012; Wright et al, 2013).…”

“…One study assessed glycemic status between day 0 (receipt of hematopoietic cells) up to day 100 (Hammer et al, 2009). Another study examined daily morning fasting glycemic status from admission up to discharge or 28 days post-transplant, whichever came first (Hammer et al, 2016). …”

“…However, people with cancer experience unique challenges to glycemic homeostasis as a consequence of cancer and its treatment (Hammer et al, 2016). Factors contributing to hyperglycemia in people with cancer include: physiologic stress, glycemic status (glucose intolerant, diagnosis of diabetes, pre or unknown diagnosis of diabetes), the administration of glucocorticoids, and changes in nutrition and activity (Dungan, Braithwaite, & Preiser, 2009; Harris et al, 2013; Hershey et al, 2014).…”