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Glycemic crises in patients with hematologic malignancies
1Division of Nursing, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Insights
Patients with blood cancers like leukemia may develop diabetes mellitus. Stress from cancer treatment can lead to life-threatening diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHNS), requiring careful medical management.
Area of Science:
- Internal Medicine
- Endocrinology
- Oncology
Background:
- Hematologic malignancies (leukemia, lymphoma, myeloma) frequently coexist with other medical conditions, including diabetes mellitus.
- The physiological and psychological stress associated with cancer diagnosis and treatment can precipitate severe diabetic complications.
Purpose of the Study:
- To highlight the risk of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHNS) in patients with hematologic malignancies.
- To emphasize the importance of heightened awareness among healthcare teams regarding these complex diabetic emergencies.
Main Methods:
- This is a review and synthesis of existing knowledge regarding the intersection of hematologic malignancies and diabetes mellitus complications.
- Focuses on clinical presentation, risk factors, and management strategies.
Main Results:
- Patients with hematologic malignancies are at increased risk for developing DKA or HHNS, particularly secondary to cancer-related stress and treatment.
- These conditions present as complex syndromes characterized by severe hyperglycemia, metabolic acidosis, and potential for systemic collapse.
Conclusions:
- Healthcare providers must maintain a high index of suspicion for DKA and HHNS in patients with hematologic malignancies.
- Collaborative care involving critical care teams and nurses is essential for optimal management of these challenging diabetic complications.
Abstract:
Persons with hematologic malignancies such as leukemia, lymphoma, or myeloma often have coexisting medical conditions. Among these may be diabetes mellitus. The physiologic and psychologic stress of diagnosis and treatment may precipitate the life-threatening complications of DKA or HHNS in this group of patients. People with personal risk factors may develop diabetes mellitus secondary to diagnosis and treatment and present with either DKA or HHNS. It is essential that the health care team have a heightened awareness of potential complications. These are complex syndromes involving severe hyperglycemia, metabolic acidosis, fluid and electrolyte imbalances, and neurologic and cardiovascular collapse. Working collaboratively with the critical care team to provide optimal care, nurses play an essential role in the management of these challenging complications of diabetes mellitus.