Diabetes and cancer: Optimising glycaemic control. Issue 2 (24th July 2022)

• Record Type: Journal Article
• Authors: Joharatnam‐Hogan, Nalinie; Morganstein, Daniel L.
• Other Names: Burden Sorrel guestEditor.; Shaw Clare guestEditor.; Barlow Rachael guestEditor.
• Is Part Of: Journal of human nutrition and dietetics. Volume 36:Issue 2(2023)
• Page Start: 504
• Page End: 513
• Publication Date: 2022-07-24
• Subjects: cancer -- diabetes -- hyperglycaemia -- outcomes; Dietetics -- Periodicals; Nutrition -- Periodicals; 613.205
• DOI: 10.1111/jhn.13051
• Languages: English
• ISSNs: 0952-3871

Abstract

Abstract: Diabetes and cancer are both common and increasingly prevalent conditions, but emerging epidemiological evidence confirms that the risk of developing a number of common cancers is increased in those with type 2 diabetes. The risk of cancer in type 1 diabetes is less clearly defined, and therefore this review focuses on type 2 diabetes. Emerging evidence also supports an influence of diabetes on outcomes of cancer treatment. However, this relationship is bi‐directional, with cancer and its treatment impacting on glucose control, whereas there is also emerging evidence indicating that diabetes care can deteriorate after a cancer diagnosis. Despite these clear links, there is a lack of evidence to guide clinicians in how to manage patients with diabetes during their cancer treatment. Although recent UK guidelines have started to address this, with the development of guidance for the management of hyperglycaemia in cancer, there is a clear need for wider guidance on the management of multi‐morbidity during cancer, including diabetes and obesity, to incorporate nutritional management. We have therefore undertaken a narrative review of the evidence of links between type 2 diabetes and cancer incidence and outcomes, and discuss the challenges to diabetes care during cancer treatment. Key points: Diabetes and cancer frequently occur together multiple solid and haematological cancers occur at increased frequency in those with type 2 diabetes multiple cancer treatments can cause hyperglycaemia or worsen control in those with diabetes. Newer targeted treatments, especially mammalian target of rapamycin and phosphoinositide 3‐kinase inhibitors, are likely to cause hyperglycaemia diabetes may also worsen cancer outcomes