Understanding the prevalence of prediabetes and diabetes in patients with cancer in clinical practice: A real-world cohort study

Dominik J. Ose, Richard Viskochil, Andreana N. Holowatyj, Mikaela Larson, Dalton Wilson, William A. Dunson, Vikrant G. Deshmukh, J. Ryan Butcher, Belinda R. Taylor, Kim Svoboda, Jennifer Leiser, Benjamin Tingey, Benjamin Haaland, David W. Wetter, Simon J. Fisher, Mia Hashibe, Cornelia M. Ulrich

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: This study aimed to understand the prevalence of prediabetes (preDM) and diabetes mellitus (DM) in patients with cancer overall and by tumor site, cancer treatment, and time point in the cancer continuum. Methods: This cohort study was conducted at Huntsman Cancer Institute at the University of Utah. Patients with a first primary invasive cancer enrolled in the Total Cancer Care protocol between July 2016 and July 2018 were eligible. Prevalence of preDM and DM was based on ICD code, laboratory tests for hemoglobin A1c, fasting plasma glucose, nonfasting blood glucose, or insulin prescription. Results: The final cohort comprised 3,512 patients with cancer, with a mean age of 57.8 years at cancer diagnosis. Of all patients, 49.1% (n=1,724) were female. At cancer diagnosis, the prevalence of preDM and DM was 6.0% (95% CI, 5.3%-6.8%) and 12.2% (95% CI, 11.2%-13.3%), respectively. One year after diagnosis the prevalence was 16.6% (95% CI, 15.4%-17.9%) and 25.0% (95% CI, 23.6%-26.4%), respectively. At the end of the observation period, the prevalence of preDM and DM was 21.2% (95% CI, 19.9%-22.6%) and 32.6% (95% CI, 31.1%-34.2%), respectively. Patients with myeloma (39.2%; 95% CI, 32.6%-46.2%) had the highest prevalence of preDM, and those with pancreatic cancer had the highest prevalence of DM (65.1%; 95% CI, 57.0%-72.3%). Patients who underwent chemotherapy, radiotherapy, or immunotherapy had a higher prevalence of preDM and DM compared with thosewho did not undergo these therapies. Conclusions: Every second patient with cancer experiences preDM or DM. It is essential to foster interprofessional collaboration and to develop evidence-based practice guidelines. A better understanding of the impact of cancer treatment on the development of preDM and DM remains critical.

Original languageEnglish
Pages (from-to)709-718
Number of pages10
JournalJNCCN Journal of the National Comprehensive Cancer Network
Volume19
Issue number6
DOIs
StatePublished - Jun 2021

Bibliographical note

Funding Information:
This work was supported by a grant from Driving out Diabetes: A Larry H. Miller Family Wellness Initiative. Research reported in this work was also supported by the NCI of the NIH under award numbers U01 CA206110, R01 CA189184, and R01 CA207371 (C.M. Ulrich), and P30 CA042014. Research reported in this work utilized the Cancer Biostatistics Shared Resource at the Huntsman Cancer Foundation at the University of Utah. Dr. Holowatyj was supported by the National Human Genome Research Institute of the NIH under Ruth L. Kirschstein National Research Service award number T32 HG008962.

Publisher Copyright:
© 2021 JNCCN-Journal of the National Comprehensive Cancer Network.

ASJC Scopus subject areas

  • Oncology

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