Management of comorbid diabetes and cancer.
Diabetes mellitus is a frequent comorbidity of cancer patients. The growing epidemic of diabetes is anticipated to have tremendous impact on health care. Diabetes may negatively impact both cancer risk and outcomes of treatment. Oncology nurses are ideally positioned to identify patients at risk for complications that arise from cancer treatment in the setting of pre-existing diabetes. Additionally, oncology nurses may be the first to identify underlying hyperglycemia/hidden diabetes in a patient undergoing cancer treatment. Strategies for assessment and treatment will be discussed, along with specific strategies for managing hyperglycemia, potential renal toxicity, and peripheral neuropathy. Guidelines for aggressive treatment of hyperglycemia to minimize risks of complications will be reviewed. The role of interdisciplinary care, utilizing current evidence, is crucial to supporting patients and their families as they manage the challenges of facing two life-limiting diseases. Whole-person assessment and individualized treatment plans are key to maximizing quality of life for patients with cancer and diabetes.
Singer
Marybeth
M
Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
D000553:Ambulatory Care; D000682:Amyloid / Q000627:therapeutic use; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*; D000077270:Exenatide; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007297:Inpatients; D007328:Insulin / Q000627:therapeutic use; D058228:Islet Amyloid Polypeptide; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D010455:Peptides / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011719:Pyrazines / Q000627:therapeutic use; D011788:Quality of Life; D012307:Risk Factors; D000068900:Sitagliptin Phosphate; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use; D014688:Venoms / Q000627:therapeutic use
D000682:Amyloid; C473734:Exubera; D007004:Hypoglycemic Agents; D007328:Insulin; D058228:Islet Amyloid Polypeptide; D010455:Peptides; D011719:Pyrazines; D014230:Triazoles; D014688:Venoms; D000077270:Exenatide; C105254:pramlintide; D000068900:Sitagliptin Phosphate