Co-Managing Patients with Type 1 Diabetes and Cancer.
The life expectancy of people with type 1 diabetes is improving and now approaches that of those without diabetes. As this population ages, a growing number will be diagnosed with and treated for cancer. Cancer treatments can drastically affect insulin requirement and glycemic control through multiple mechanisms including high doses of glucocorticoids and targeted therapies that directly interfere with cellular pathways involved in the action of insulin. Patients with cancer frequently also have alterations in gastrointestinal motility or appetite and require supplemental enteral or parenteral nutrition. Few studies have evaluated these patients directly, but data on patients with and without diabetes suggest that glycemic control may play a larger role in cancer outcomes than is often recognized. Collaboration between the treating oncologist and diabetologist allows people with diabetes to receive the most effective therapies for their cancers without undue risk of hypoglycemia or adverse outcomes due to hyperglycemia.
MD Anderson Cancer Center, Endocrine Neoplasia and Hormonal Disorders, 1400 Pressler St. Unit 1461, Houston, TX, 77030-4009, USA. cjbest@mdanderson.org.
Conor J
CJ
Best
MD Anderson Cancer Center, Endocrine Neoplasia and Hormonal Disorders, 1400 Pressler St. Unit 1461, Houston, TX, 77030-4009, USA.
Sonali
S
Thosani
MD Anderson Cancer Center, Endocrine Neoplasia and Hormonal Disorders, 1400 Pressler St. Unit 1461, Houston, TX, 77030-4009, USA.
Marjorie
M
Ortiz
MD Anderson Cancer Center, Endocrine Neoplasia and Hormonal Disorders, 1400 Pressler St. Unit 1461, Houston, TX, 77030-4009, USA.
Celia
C
Levesque
MD Anderson Cancer Center, Endocrine Neoplasia and Hormonal Disorders, 1400 Pressler St. Unit 1461, Houston, TX, 77030-4009, USA.
Sigi S
SS
Varghese
MD Anderson Cancer Center, Endocrine Neoplasia and Hormonal Disorders, 1400 Pressler St. Unit 1461, Houston, TX, 77030-4009, USA.
Victor R
VR
Lavis
D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000628:therapy*; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy; D007167:Immunotherapy; D007328:Insulin / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome
D007328:Insulin
Cancer; Chemotherapy; Glucocorticoids; Hyperalimentation; Targeted cancer therapy; Type 1 diabetes