The management of diabetes in patients with advanced cancer.
The management of diabetes mellitus is often complicated in patients with advanced cancer. Anorexia and nausea or vomiting make caloric intake erratic. The use of diabetogenic medications such as glucocorticoids can produce profound hyperglycemia. Many malignant tumors cause derangement in intermediary metabolism and abnormal glucose tolerance in up to one-third of patients. Both hyperglycemia and hypoglycemia impair the quality of life of dying patients. Swings in blood sugar should be avoided wherever possible, but aggressive blood sugar monitoring also impairs quality of life. This paper discusses issues in the management of diabetes in patients with advanced cancer and suggests guidelines for maintaining glycemic control without excessive interventions.
Poulson
J
J
Department of Medicine, University of Toronto, Ontario, Canada.
D001786:Blood Glucose / Q000187:drug effects; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000628:therapy; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D005905:Glyburide / Q000627:therapeutic use; D017408:Guidelines as Topic; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000209:etiology; D007003:Hypoglycemia / Q000188:drug therapy / Q000209:etiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000150:complications* / Q000628:therapy; D011788:Quality of Life; D013479:Superior Vena Cava Syndrome / Q000150:complications / Q000628:therapy; D019452:Terminally Ill
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D005905:Glyburide