Patient-Centered Diabetes Care of Cancer Patients

Anupam Kotwal, Yee Ming M. Cheung, Grace Cromwell, Andjela Drincic, Houry Leblebjian, Zoe Quandt, Robert J. Rushakoff, Marie E. McDonnell

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

Purpose of Review: There is a bidirectional relationship between cancer and diabetes, with one condition influencing the prognosis of the other. Multiple cancer therapies cause diabetes including well-established medications such as glucocorticoids and novel cancer therapies such as immune checkpoint inhibitors (CPIs) and phosphoinositide 3-kinase (PI3K) inhibitors. Recent Findings: The nature and severity of diabetes caused by each therapy differ, with some predominantly mediated by insulin resistance, such as PI3K inhibitors and glucocorticoids, while others by insulin deficiency, such as CPIs. Studies have demonstrated diabetes from CPIs to be more rapidly progressing than conventional type 1 diabetes. There remains a scarcity of published guidance for the screening, diagnosis, and management of hyperglycemia and diabetes from these therapies. The need for such guidance is critical because diabetes management in the cancer patient is complex, individualized, and requires inter-disciplinary care. Summary: In the present narrative review, we synthesize and summarize the most relevant literature pertaining to diabetes and hyperglycemia in the setting of these cancer therapies and provide an updated patient-centered framework for their evaluation and management.

Original languageEnglish (US)
Article number62
JournalCurrent diabetes reports
Volume21
Issue number12
DOIs
StatePublished - Dec 2021

Keywords

  • Diabetes mellitus
  • Glucocorticoid
  • Hyperglycemia
  • Immune checkpoint inhibitor
  • PI3 kinase inhibitor

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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