Optimizing glycemic control in oncology patients with diabetes mellitus

BackgroundCo-morbidity cancer and diabetes mellitus is a complex clinical issue due to the fact that cancer treatments, corticosteroid use, and polypharmacy can greatly interfere with glycemic control and predispose patients to the risk of metabolic complications and adverse drug events.ObjectivesThe study is proposed to analyze the glycemic control patterns, examine the treatment-related factors impacting the metabolic variability, and to identify the drug-related problems to facilitate safer and more efficient treatment of the oncology patients with diabetes.MethodsA prospective observational study design is conducted on 132 diabetic patients with diabetes mellitus who are oncology patients in a tertiary care setting. Descriptive and advanced statistical tests that assessed normality (Jarque-Bera, Lilliefors tests), categorical associations (exact test by Boschloo). Further, the non-parametric group and trend analysis (van der Waerden and Betsch-Ebner tests) are leveraged to gather and analyze the collected demographic, clinical, pharmacological, and biochemical parameters.ResultsThe glycemic variables are found to have significant non-normal distribution (p < 0.05). The use of steroids is closely related to hyperglycemia (p = 0.006), whereas polypharmacy is significantly related to drug-related issues (p = 0.002). Mean fasting blood glucose level dropped to 130 mg/dl at discharge after 180 mg/dl at admission and the proportion of patients with good glycemic control increased to 99% as opposed to 65% at the time of admission.ConclusionThe results indicate that oncology patients having diabetes face a high risk of glycemic labile caused by treatments, especially, corticosteroid exposure and combinations of complicated medications.