Glycosylated Hemoglobin A1c and Lack of Association With Symptom Severity in Patients Undergoing Chemotherapy for Solid Tumors.
OBJECTIVE
To assess the effects of high blood sugar at the levels of diabetic or prediabetic states during cancer treatment because patients undergoing chemotherapy (CTX) experience multiple symptoms that vary among individuals and may be affected by glucose levels.


METHODS
Descriptive, cross-sectional.


METHODS
Two comprehensive cancer centers, one Veterans Affairs hospital, and four community-based oncology programs.


METHODS
244 outpatients with breast, gastrointestinal, gynecologic, and lung cancers.


METHODS
Patients completed demographic and symptom questionnaires. Glycosylated hemoglobin A1c (HbA1c) was evaluated to determine diabetic state. Descriptive statistics and one-way analyses of variance were used in the analyses.


METHODS
HbA1c, symptom severity scores, patient and clinical characteristics (e.g., age, gender, comorbidities, sociodemographic information, body mass index [BMI], lifestyle factors).


RESULTS
HbA1c results showed 9% of the sample in the diabetic and 26% in the prediabetic state. Patients in the diabetic state reported a higher number of comorbid conditions and were more likely to be African American. Patients in the prediabetic state were older aged. Patients in the diabetic and prediabetic states had a higher BMI compared to nondiabetic patients. No differences in symptom severity or quality-of-life (QOL) scores were found among the three diabetic states.


CONCLUSIONS
This study is the first to evaluate for associations between diabetic states and symptom severity and QOL scores in patients receiving CTX. This study confirmed that older age, as well as having higher BMI and having multiple comorbidities, were associated with increased mean glycemic levels.


CONCLUSIONS
Clinicians should assess and identify patients with diabetes or prediabetes undergoing treatment for cancer. Patients who are older aged, those with a high BMI, and those with multiple comorbid conditions may be at increased risk for higher glycemic states.
College of Nursing, New York University in New York.
Marilyn J
MJ
Hammer
Bradley E
BE
Aouizerat
New York University.
Brian L
BL
Schmidt
Mount Sinai Hospital in New York.
Frances
F
Cartwright
New York University.
Fay
F
Wright
Christine
C
Miaskowski
D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000188:drug therapy*; D011236:Prediabetic State / Q000097:blood; D011788:Quality of Life; D012720:Severity of Illness Index
D006442:Glycated Hemoglobin
breast cancer; chemotherapy; gastrointestinal cancer; glycosylated hemoglobin A1c; gynecologic cancer; lung cancer; symptom severity