Incidences of diabetes and prediabetes among female adult breast cancer patients after systemic treatment

Abstract

Patients with cancer frequently show glucose intolerance. This study is to estimate the status of total diabetes and prediabetes in breast cancer patients after systemic treatment through an oral glucose tolerance test (OGTT) in China. All the 119 breast cancer patients more than 3 months after systemic treatment with surgery and chemotherapy participated in the study. All the patients without the diagnosis of diabetes underwent OGTT, and fasting and 2-h glucose levels were measured to identify undiagnosed diabetes and prediabetes. Previously diagnosed diabetes were determined on the self-report and the medical record. Of the 119 breast cancer patients, with the median age of 50.1 years and the mean age of about 48 years when they were initially diagnosed with breast cancer, which showed the similar characters of China and Asia breast cancer patients, the overall incidences of total diabetes and prediabetes were 21.8 and 43.7 %, respectively. About 80 % of the diabetes were previously undiagnosed. About 80.0 % of the cases of undiagnosed diabetes and prediabetes met the criteria for elevated 2-h plasma glucose levels through OGTT but not the criteria for elevated fasting glucose levels. Our study firstly documents high incidences of previously undiagnosed diabetes and prediabetes in breast cancer patients during follow-up after systemic treatment through OGTT, indicating that greater diabetes screening, especially through OGTT, prevention, and treatment strategies among breast cancer patients, after systemic treatment for these patients is needed.

Glycosylated Hemoglobin A1c and Lack of Association With Symptom Severity in Patients Undergoing Chemotherapy for Solid Tumors

“…Among the diabetic states, 63% of the patients were nondiabetic, 26% were prediabetic, and 9% were diabetic. These percentages are lower than previous studies, which found that 44% of patients with cancer had prediabetes, and from 19% (Bhatnagar et al, 2014) to 22% (Ji et al, 2013) of patients had diabetes. Reasons for these differences are not readily apparent and warrant additional investigation.…”

Acute Hyperglycemia Associated with Anti-Cancer Medication

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

On the Status and Comparison of Glucose Intolerance in Female Breast Cancer Patients at Initial Diagnosis and during Chemotherapy through an Oral Glucose Tolerance Test

“…However, in those studies, OGTT were not performed in the entire study population; therefore, the true incidence of undiagnosed diabetes may have been underestimated. Therefore, in the previous research, we firstly studied the status of total diabetes and prediabetes in breast cancer patients after systemic treatment through OGTT in Southwest of China and found that the overall incidences of total diabetes and prediabetes were 21.8% and, 43.7%, respectively; about 80% of the diabetes were previously undiagnosed; about 80.0% of the cases of undiagnosed diabetes and, prediabetes met the criteria for elevated 2-hour plasma glucose levels through OGTT but not the criteria for elevated fasting glucose levels [16].…”

“…The previously reported findings have not all been consistent, owing to methodological differences in sampling and to differences in the criteria used to define diabetes [15]. Furthermore, the prevalences of diabetes and prediabetes were probably under estimated in these studies because 2-hour oral glucose-tolerance tests (OGTT) were not performed in all participants [16]. It has been reported that isolated hyperglycemia 2 hours after glucose loading is common among Asian diabetic patients [17].…”

“…Our previous study on the status of total diabetes and prediabetes in breast cancer patients after systemic treatment through OGTT in Southwest of China showed that the overall incidences of total diabetes and prediabetes were 21.8% and 43.7%, respectively; about 80% of the diabetes were previously undiagnosed; about 80.0% of the cases of undiagnosed diabetes and prediabetes met the criteria for elevated 2-hour plasma glucose levels through OGTT instead of the criteria for elevated fasting glucose levels [16]. However, there have been no detailed studies about the status and comparison of isolated hyperglycemia 2 hours after glucose loading in breast cancer patients at initial diagnosis and during chemotherapy through OGTT.…”