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Short-term adverse effects of anticancer drugs in patients with type 2 diabetes

Agostino Milluzzo1, Andrea Tumminia1, Veronica Vella1,2

  • 1a Department of Clinical and Experimental Medicine , Endocrinology Section, University of Catania Medical School , Garibaldi-Nesima Hospital , Catania , Italy.

Journal of Chemotherapy (Florence, Italy)
|February 12, 2019
PubMed

Insights

Anticancer drugs can worsen glycemic control and diabetes complications in patients with type 2 diabetes. Management often requires intensifying diabetes therapy, particularly with insulin, due to these adverse effects.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Short-term adverse effects of anticancer drugs (AD) in type 2 diabetes (T2D) patients are understudied.
  • Managing T2D during cancer treatment presents significant clinical challenges.

Purpose of the Study:

  • To evaluate the short-term impact of first-line AD on glycemic control in T2D patients.
  • To assess the effects of AD on chronic diabetes complications.
  • To identify predictors for intensified diabetes therapy.

Main Methods:

  • Retrospective, single-center study.
  • Involved 168 patients with T2D and cancer.
  • Analyzed glycemic control (HbA1c) and diabetes complications before and after AD initiation.

Main Results:

  • Average HbA1c increased significantly post-AD treatment (7.5% vs. 7.1%).
  • Diabetes therapy intensification was needed in 46.4% of patients, primarily with insulin (82.1%).
  • Alkylating agents and high-dose glucocorticoids predicted therapy intensification. Liver enzymes increased, eGFR decreased (12.5%), and kinase inhibitors increased microalbuminuria risk.

Conclusions:

  • First-line anticancer drugs significantly impact glycemic control and kidney function in T2D patients.
  • Close monitoring and proactive management are crucial for T2D patients undergoing cancer therapy.
  • Specific drug classes require careful consideration due to their potential to exacerbate diabetes complications.
Keywords:
Anticancer treatmentCancerChronic complicationsDiabetesDiabetes and CancerMetabolic control

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