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

Abstract

AimsThis study is to estimate the status and comparison of glucose intolerance in female breast cancer patients at initial diagnosis and during chemotherapy through an oral glucose tolerance test (OGTT), as well as to learn the effect of chemotherapy on the glucose metabolism of breast cancer patients.MethodsAll the 79 breast cancer patients at initial diagnosis, with the mean age of 53.2 years, and 96 breast cancer patients before the 5th or 6th cycle of chemotherapy, with the mean age of 51.5 years, participated in the study from December 2012 to October 2013. After an overnight fast, participants underwent OGTT test, and fasting and 2-hour glucose levels were measured to identify undiagnosed diabetes and prediabetes (i.e., impaired fasting glucose or impaired glucose tolerance) in them. Previously diagnosed diabetes among the female breast cancer patients was determined on the self-report and the medical record.ResultsThe overall incidences of total normal glucose tolerance, prediabetes, diabetes in female breast cancer patients at initial diagnosis and during chemotherapy were 24.1% and 38.5% (p<0.05), 50.6% and 28.1% (p<0.05), and 25.3% and 33.3% (p>0.05), respectively, and the differences of normal glucose tolerance and prediabetes instead of diabetes between the two groups were statistically significant. About 84% of the total diabetes and prediabetes in the female breast cancer patients at initial diagnosis and 79.7% of those during chemotherapy need to be diagnosed with OGTT.ConclusionsBreast cancer patients have high incidences of diabetes and prediabetes. After chemotherapy even with steroids, some breast cancer patients with abnormal glucose metabolism may even become normal. Isolated hyperglycemia 2 hours after glucose loading is common, and OGTT should be made for breast cancer patients at initial diagnosis and during chemotherapy.

High prevalence of diabetes mellitus and impaired glucose tolerance in liver cancer patients: A hospital based study of 4610 patients with benign tumors or specific cancers

“…High fat and carbohydrate diets, associated with dietary carcinogenesis, contribute to abnormal glucose tolerance and cancer 1 , 2 . Previous studies suggest that metabolic syndrome is associated with a modestly increased risk of second breast cancer events and breast cancer-specific mortality 3 .…”

Impaired fasting glucose in breast cancer survivors of a general hospital at Mexico City: A case series study

“…We must point out that in breast cancer survivors, impaired fasting glucose increases the risk of developing type 2 diabetes mellitus, and the coincidence of type 2 diabetes mellitus with inadequate metabolic control increases cancer recurrence and mortality. [89] In addition, impaired fasting glucose increases the risk of other new carcinomas and all-cause mortality. [121314] These circumstances are significant because the number of breast cancer survivors is rising worldwide.…”

“…[7] Besides, in these survivors, impaired fasting glucose is a high-risk factor to develop type 2 diabetes mellitus. [8] Women with advanced breast cancer and type 2 diabetes mellitus had bigger possibilities of cancer recurrence. [9]…”

Perspectives on diabetes mortality as the result of residual confounding and reverse causality by common disease

“…Few studies have addressed glycaemic control after treatment in patients with other types of cancer. A small cross‐sectional study of Chinese women with breast cancer showed that the prevalence of diabetes and pre‐diabetes was statistically significantly lower in women undergoing chemotherapy than in women who had just been diagnosed with breast cancer . Although the causality cannot be established, and the study had methodological drawbacks related to the lack of comparative measures of glycaemic control for the same patients and the lack of control for changes in dietary factors before and during chemotherapy, the authors speculated that this could be the result of a decrease in diabetes‐inducing factors following from the cancer itself.…”