title: Diabetology and oncology meet in a network model: union is strength.
abstract: Diabetes and cancer are increasingly common conditions, and the management of cancer patients with diabetes is often challenging. Diabetes in cancer patients poses several complex clinical issues, including which treatment is suitable to control hyperglycemia, how to better counteract glucocorticoid-induced hyperglycemia, and how to manage nutritional problems of cachectic patients and glucose variability linked to artificial nutrition. A key aspect to consider is the patients' position on the trajectory of the oncologic disease, both to establish which level of glycemic control should be pursued and to decide the most suitable antidiabetic treatment to recommend. Endocrinologists are rarely involved in the management of patients with advanced cancer. Furthermore, lack of guidelines results in a "trial-and-error" approach, often with suboptimal disease management. Lastly, cancer survivors represent a frequently underestimated category of patients at higher cardiometabolic risk. A practical solution for these challenges lies in the implementation of care networks based on a close partnership and ongoing communication between oncologists, endocrinologists, and nutritionists, placing the patient at the center of the care process. At the same time, universities and scientific societies should play a key role in promoting research into areas of intersection of oncology and endocrinology, in raising awareness of common possibilities of primary and secondary prevention of metabolic and oncologic diseases, as well as specific challenges of managing diabetes and cancer, and proper training of health workers, while also supporting the shared implementation of effective management strategies.
authors: Oncological Endocrinology Unit, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Turin, Italy. mgallo4@cittadellasalute.to.it.
authors: Marco
authors: http://orcid.org/0000-0001-7166-0848
authors: M
authors: Gallo
authors: Endocrinology and Diabetes Unit, Cardinal Massaja Hospital, Asti, Italy.
authors: Luigi
authors: L
authors: Gentile
authors: School of Medicine, University of Turin, Turin, Italy.
authors: Emanuela
authors: E
authors: Arvat
authors: Head of the Piemonte and Valle d'Aosta Oncology Network, Turin, Italy.
authors: Oscar
authors: O
authors: Bertetto
authors: Institute of Food Science, National Research Council, IRPPS - Institute for Research on Population and Social Policies, Penta di Fisciano, Salerno, Italy.
authors: Gennaro
authors: G
authors: Clemente
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications / Q000628:therapy*; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D010348:Patient Care Team
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents
keywords: Artificial nutrition; Cancer; Cancer survivors; Clinical management; Diabetes; Glucocorticoids