title: The impact of diabetes on neuropathic symptoms and receipt of chemotherapy among colorectal cancer patients: results from the PROFILES registry.
abstract: OBJECTIVE
  This study assessed differences in neuropathic symptoms between colorectal cancer (CRC) patients with and without diabetes. Moreover, we aimed to explore whether neuropathic symptoms could be explained by the receipt of chemotherapy as it was previously shown that cancer patients with diabetes less often receive chemotherapy.
  
  
  METHODS
  Data from a cross-sectional study among CRC patients (2-11 years after diagnosis) was used. Data were collected by the Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship (PROFILES) registry which is linked to clinical data from the population-based Eindhoven Cancer Registry. Diabetes status was self-reported and neuropathic symptoms were measured with the European Organization for Research and Treatment of Cancer quality of life questionnaire-chemotherapy-induced peripheral neuropathy 20 (EORTC QLQ-CIPN20).
  
  
  RESULTS
  Two hundred eighteen CRC patients with diabetes were matched on age and sex to 975 CRC patients without diabetes. After adjustments for cancer treatment including chemotherapy and other covariates, logistic regression models showed that CRC patients with diabetes experienced more mild to severe neuropathic symptoms, including tingling fingers or hands (odds ratio (OR) = 1.40; 95% confidence interval (CI) 1.00-1.94), tingling toes or feet (OR = 1.47; 95% CI 1.04-2.07), numbness in toes or feet (OR = 1.83; 95% CI 1.28-2.62), and erection problems among men (OR = 1.83; 95% CI 1.11-3.03) as compared to CRC patients without diabetes. No differences in cancer treatment were found between CRC patients with and without diabetes.
  
  
  CONCLUSIONS
  CRC patients with diabetes experienced more neuropathic symptoms, regardless of cancer treatment, suggesting that diabetes itself rather than treatment with chemotherapy results in more neuropathic symptoms among cancer patients with diabetes compared to those without.
  
  
  CONCLUSIONS
  Up to 39% of cancer survivors might expect mainly mild, neuropathic symptoms, with more symptoms among patients with co-occurring diabetes.
authors: CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, Netherlands, p.a.j.vissers@tilburguniversity.edu.
authors: Pauline A J
authors: PA
authors: Vissers
authors: Floortje
authors: F
authors: Mols
authors: Melissa S Y
authors: MS
authors: Thong
authors: Frans
authors: F
authors: Pouwer
authors: Gerard
authors: G
authors: Vreugdenhil
authors: Lonneke V
authors: LV
authors: van de Poll-Franse
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D004358:Drug Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010523:Peripheral Nervous System Diseases; D011788:Quality of Life; D017741:Survivors
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