Incidence of Hyperglycemia/Secondary Diabetes in Women who have Undergone Curative Chemotherapy for Breast Cancer: First Study from India

Abstract

Purpose Development of cancer chemotherapy treatment-induced hyperglycemia/ diabetes (secondary diabetes) is a major problem and has never been reported from India. The present study was planned to ascertain this in women undergoing curative chemotherapy for their breast cancer. Materials and Methods This was a retrospective chart-based study and was conducted in a cancer specialty hospital. The information on women who were nondiabetic at the start of the treatment was collected from the files. Details on cancer diagnosis, domicile, body mass index (BMI), type of diet, marital status, number of children, and previous history of diabetes if any were considered. The blood glucose levels before surgery and after the completion of radiotherapy were considered. World Health Organization (WHO) guidelines for diabetes were considered. The data were subjected to frequency and percentage and analyzed using Chi-square test. Association between the demographic details and development of Hyperglycemia or secondary diabetes or prediabetes was done using the Pearson’s correlation analysis. p < 0.05 was considered as statistically significant. Results A total of 474 cases were included in accordance with the inclusion criteria. The results indicated that by the end of the radiation treatment, 24.89% were prediabetic, 10.97% were diabetic after being in prediabetic stage, 8.22% became diabetic without going through a prediabetic stage, and that 55.91% did not develop either prediabetic or diabetic condition. Analysis of development of secondary diabetes and prediabetes with BMI (p < 0.0001) and age (p < 0.024) showed a strong correlation and was significant. Conclusion To the best of the authors’ knowledge, this is the first study from India, and the results indicate that the development of secondary diabetes in women undergoing curative chemotherapy is high. Attempts are underway to ascertain the cause for the development and how it can be mitigated.

Link between Blood Cell-Associated Inflammatory Indices and Chemotherapy-Induced Hyperglycemia in Women Affected with Breast Cancer: Clinical Studies

“…7 Our observations of the study suggested that by the end of the radiation treatment (which is the modality adopted after completion of surgery and chemotherapy), 24.89% were prediabetic, 10.97% were diabetic after being in the prediabetic stage, 8.22% became diabetic without going through a prediabetic stage, and only 55.91% did not develop either per diabetic or diabetic condition. 7 A strong correlation was also observed between the development of secondary hyperglycemia/diabetes and prediabetes with body mass index (BMI) and age. 7 From a biochemical perspective, accumulating evidence from innumerable clinical observations have conclusively shown that chronic inflammation plays a central role in the development and progression of both diabetes and cancer.…”

“…7 A strong correlation was also observed between the development of secondary hyperglycemia/diabetes and prediabetes with body mass index (BMI) and age. 7 From a biochemical perspective, accumulating evidence from innumerable clinical observations have conclusively shown that chronic inflammation plays a central role in the development and progression of both diabetes and cancer. [19][20][21][22] Reports suggest that when compared with the nondiabetic population, the incidence of gastric, liver, pancreatic, colorectal, urinary tract, breast, and female reproductive cancers is high in type II diabetes, and is accompanied by higher mortality.…”

“…From a terminological perspective, secondary hyperglycemia/diabetes is when a normoglycemic (nondiabetic) individual develops hyperglycemia/diabetes after treatment with any pharmacologic agent/s. 6,7 With regard to cancer, reports suggest that administration of certain anticancer drugs and the use of dexamethasone, an important steroidal antiemetic agent effective in mitigating chemotherapy-induced nausea and vomiting is proved to cause secondary hyperglycemia/diabetes. [7][8][9][10][11][12][13][14][15][16][17][18] Recently, we have observed that in normoglycemic Indian women undergoing curative treatment for breast cancer, the incidence of development of glucose intolerance was high.…”

“…6,7 With regard to cancer, reports suggest that administration of certain anticancer drugs and the use of dexamethasone, an important steroidal antiemetic agent effective in mitigating chemotherapy-induced nausea and vomiting is proved to cause secondary hyperglycemia/diabetes. [7][8][9][10][11][12][13][14][15][16][17][18] Recently, we have observed that in normoglycemic Indian women undergoing curative treatment for breast cancer, the incidence of development of glucose intolerance was high. 7 Our observations of the study suggested that by the end of the radiation treatment (which is the modality adopted after completion of surgery and chemotherapy), 24.89% were prediabetic, 10.97% were diabetic after being in the prediabetic stage, 8.22% became diabetic without going through a prediabetic stage, and only 55.91% did not develop either per diabetic or diabetic condition.…”

“…[7][8][9][10][11][12][13][14][15][16][17][18] Recently, we have observed that in normoglycemic Indian women undergoing curative treatment for breast cancer, the incidence of development of glucose intolerance was high. 7 Our observations of the study suggested that by the end of the radiation treatment (which is the modality adopted after completion of surgery and chemotherapy), 24.89% were prediabetic, 10.97% were diabetic after being in the prediabetic stage, 8.22% became diabetic without going through a prediabetic stage, and only 55.91% did not develop either per diabetic or diabetic condition. 7 A strong correlation was also observed between the development of secondary hyperglycemia/diabetes and prediabetes with body mass index (BMI) and age.…”