title: Secondary diabetes associated with 5-fluorouracil-based chemotherapy regimens in non-diabetic patients with colorectal cancer: results from a single-centre cohort study.
abstract: OBJECTIVE
  The aim of the study was to analyse the prevalence and characteristics of secondary diabetes induced by 5-fluorouracil (5-FU) based chemotherapy in non-diabetic patients with colorectal cancer (CRC).
  
  
  METHODS
  A total of 422 consecutive CRC patients who received 5-FU-based chemotherapy were retrospectively analysed. Fasting plasma glucose (FPG) levels were determined before each cycle of chemotherapy during active treatment and regular follow-up. The prevalence and characteristics of secondary hyperglycaemia were investigated, with special focus on the clinical outcome.
  
  
  RESULTS
  Among the 422 CRC patients, 60 had pre-existing hyperglycaemia. In the remaining 362 with normal FPG levels before chemotherapy, 42 (11.6%) and 41 (11.3%) patients developed diabetes and impaired fasting glucose during the study period. Among the 42 secondary diabetic patients, 22 (52.4%) received anti-diabetes drug therapy, in 7 (16.7%) cases the FPG level returned to normal without any active intervention, and 13 (30.9%) cases received diet control and physiotherapy. Thirty-one (8.6%) patients developed diabetes. Based on the Common Terminology Criteria for Adverse Events, an adverse event over Grade 3 occurred in seven cases during follow-up. Diabetes-related adverse events had a serious negative impact on chemotherapy in six cases. Diabetes-related death occurred in three patients.
  
  
  CONCLUSIONS
  Secondary diabetes associated with 5-FU-based chemotherapy occurs in around 10% of CRC patients, with a significant negative impact on treatment and clinical outcome. 5-FU-related diabetes should be regarded as a common side effect of 5-FU treatment.
authors.affiliation: Department of Oncology, Wuhan Pu-Ai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. fengjuepingpuai@gmail.com
authors.forename: J-P
authors.initials: JP
authors.lastname: Feng
authors.forename: X-L
authors.initials: XL
authors.lastname: Yuan
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Fang
authors.forename: T
authors.initials: T
authors.lastname: Xie
authors.forename: Y
authors.initials: Y
authors.lastname: Zhou
authors.forename: Y-M
authors.initials: YM
authors.lastname: Zhu
authors.forename: M
authors.initials: M
authors.lastname: Luo
authors.forename: M
authors.initials: M
authors.lastname: Lin
authors.forename: D-W
authors.initials: DW
authors.lastname: Ye
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D002096:C-Peptide / Q000097:blood; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003920:Diabetes Mellitus / Q000097:blood / Q000139:chemically induced* / Q000628:therapy; D005247:Feeding Behavior; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects*; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced / Q000628:therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D002096:C-Peptide; D007004:Hypoglycemic Agents; D005472:Fluorouracil