title: The management of diabetes in terminal illness related to cancer.
abstract: The management of diabetes during terminal illness is complex, with lack of agreement and consensus among physicians and multidisciplinary teams. Despite the plethora of guidelines available for the management of diabetes, there exists no agreed, evidence-based strategy for managing diabetes during terminal illness and at the end of life. A number of physiological factors may influence glycaemic control during terminal illness. These include anorexia, cachexia, malabsorption, renal and hepatic failure. Furthermore, controversy exists on the frequency of blood glucose monitoring, the optimum blood glucose range and how to achieve this. We review the factors influencing blood glucose during terminal illness and provide a suggested approach to managing patients with type 1 and type 2 diabetes during the early and late stages of terminal illness.
authors.affiliation: Department of Diabetes and Endocrinology, Morriston Hospital, ABM University NHS Trust, Swansea, UK.
authors.forename: E J
authors.initials: EJ
authors.lastname: King
authors.forename: H
authors.initials: H
authors.lastname: Haboubi
authors.forename: D
authors.initials: D
authors.lastname: Evans
authors.forename: I
authors.initials: I
authors.lastname: Baker
authors.forename: S C
authors.initials: SC
authors.lastname: Bain
authors.forename: J W
authors.initials: JW
authors.lastname: Stephens
mesh_terms: D000465:Algorithms; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007674:Kidney Diseases / Q000209:etiology; D008107:Liver Diseases / Q000209:etiology; D009369:Neoplasms / Q000150:complications*; D010353:Patient Education as Topic; D012307:Risk Factors; D013727:Terminal Care / Q000379:methods*; D019452:Terminally Ill
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin