Hypoglycemia Associated With Neoplasia*

Marks, Leon J.; Steinke, Jürgen; Podolsky, Stephen; Egdahl, Richard H.

doi:10.1111/j.1749-6632.1974.tb14443.x

Cited by 34 publications

(15 citation statements)

References 29 publications

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“…Malnutrition and cachexia occur in cancer patients as a result of loss of appetite due to the cancer itself and to medications, including chemotherapy 43 . In patients with advanced cancer, hypoglycemia is also occasionally found 44 . Some specific organ cancers, including pancreas 45 .…”

Section: Discussionmentioning

confidence: 99%

Incidence rate and patient characteristics of severe hypoglycemia in treated type 2 diabetes mellitus patients in Japan: Retrospective Diagnosis Procedure Combination database analysis

Ikeda

Kubo

Oda³

et al. 2018

J of Diabetes Invest

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Aims/IntroductionTo evaluate the incidence rate of and identify factors associated with severe hypoglycemic episodes in patients with treated type 2 diabetes mellitus.Materials and MethodsUsing Diagnosis Procedure Combination hospital‐based medical database, we carried out a retrospective cohort study to assess the incidence rate of severe hypoglycemia in treated type 2 diabetes mellitus patients. We evaluated the associations between severe hypoglycemia and age, sex, complications, and current use of insulin or sulfonylurea (SU) in a nested case–control study.ResultsOf 166,806 eligible patients, 1,242 had episodes of severe hypoglycemia during the observational period. The incidence rate of the first hypoglycemic events was 3.70/1,000 patient years. Based on the nested case–control analysis, age was associated with hypoglycemic events with adjusted odds ratios (ORs) of 1.64 or 65–74‐year‐old patients and 3.79 for ≥75‐year‐old patients in comparison with 20–64‐year‐old patients. Comorbidities, such as cognitive impairment, cancer, macrovascular disease and diabetic complications (retinopathy, nephropathy and neuropathy), were associated with severe hypoglycemia, with adjusted ORs ranging from 1.25 to 3.80. Severe hypoglycemic events also increased in patients with current use of both SU and insulin, either SU or insulin, with adjusted ORs of 18.36, 6.31 or 14.07, respectively, compared with patients with other antihyperglycemic agents. In patients with an SU glimepiride, adjusted ORs increased dose‐dependently from 3.65 (≤1 mg) to 13.34 (>2 mg).ConclusionsThe incidence rate of severe hypoglycemia in this cohort was 3.70/1,000 patient years. Age, cognitive impairment, cancer, diabetic complications, current use of insulin + SU and SU dosage were identified as risk factors for severe hypoglycemia.

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Section: Discussionmentioning

confidence: 99%

Incidence rate and patient characteristics of severe hypoglycemia in treated type 2 diabetes mellitus patients in Japan: Retrospective Diagnosis Procedure Combination database analysis

Ikeda

Kubo

Oda³

et al. 2018

J of Diabetes Invest

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show abstract

“…This observation opens an avenue of potential significance in tumor diagnosis, management, and treatment, warranting further investigation. Notable in this regard, for instance, is the rare but documented occurrence of clinically asymptomatic hypoglycemia and lactic acidosis in certain nonpancreatic malignancies, especially lymphomas, which has been attributed to an extreme manifestation of the Warburg effect (33)(34)(35).…”

Section: Discussionmentioning

confidence: 99%

Vhl deletion in osteoblasts boosts cellular glycolysis and improves global glucose metabolism

Dirckx

Tower

Mercken

et al. 2018

Journal of Clinical Investigation

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“…Although several hypotheses have been advanced to explain cancer anorexia (6)(7)(8)(9)(10)(11), they have generally failed to investigate neurological mechanisms known to influence food intake in normal organisms. Fewer of these hypotheses have considered mechanisms of interaction of a distant tumor on brain feeding and satiety systems.…”

Section: Introductionmentioning

confidence: 98%

Insulin reverses ammonia‐induced anorexia and experimental cancer anorexia

Chance

Thomas

Fischer

1994

Nutrition and Cancer

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Previous experiments suggest that experimental cancer-induced anorexia is associated with hyperammonemia and that daily injections of insulin may attenuate the anorexia for several days. In the present study, we determined whether similar daily insulin treatments would correct anorexia induced by the infusion of ammonium salts and compared this feeding response with that of insulin-treated tumor-bearing (TB) rats. Daily treatment of control and anorectic TB rats with systemically administered insulin for six days increased feeding in all control rats and 40% of the TB rats. All insulin-treated groups exhibited equal degrees of hypoglycemia irrespective of anorexia. Basal concentrations of lactate and glucagon were elevated in saline-treated TB rats. Plasma lactate levels were normalized by insulin treatment, whereas glucagon was normalized only in the TB rats that fed to insulin and increased further in TB rats that did not feed to insulin. Elevated hypothalamic tyrosine was reduced in insulin-treated TB rats that ate, and 5-hydroxy-indoleacetic acid was increased further when the rats did not eat. Insulin also blocked anorexia resulting from the intravenous infusion of ammonium salts. Hypothalamic concentrations of tyrosine and tryptophan were increased by the ammonia infusion and reduced significantly in insulin-treated infused rats. These results indicate that insulin treatment can reverse experimental cancer-induced anorexia and hyperammonemia-induced anorexia. Neurochemical changes associated with these treatments are also similar, but not identical.

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Hypoglycemia Associated With Neoplasia*

Cited by 34 publications

References 29 publications

Incidence rate and patient characteristics of severe hypoglycemia in treated type 2 diabetes mellitus patients in Japan: Retrospective Diagnosis Procedure Combination database analysis

Incidence rate and patient characteristics of severe hypoglycemia in treated type 2 diabetes mellitus patients in Japan: Retrospective Diagnosis Procedure Combination database analysis

Vhl deletion in osteoblasts boosts cellular glycolysis and improves global glucose metabolism

Insulin reverses ammonia‐induced anorexia and experimental cancer anorexia

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