The Impact of Cancer on Diabetes Outcomes

Overview

Journal BMC Endocr Disord

Publisher Biomed Central

Specialty Endocrinology

Date 2019 Jun 13

PMID 31185995

Citations 10

Authors

Anne Beiter Arreskov

Maria A Olsen

Sandra Sinius Pouplier

Volkert Siersma

Christen L Andersen

Soren Friis

Niels de Fine Olivarius

Affiliations

Soon will be listed here.

Abstract

Background: Survival from many cancer types is steadily increasing, and as a result, a growing number of cancer patients will live with other chronic diseases, of which diabetes is one of the most prevalent. This study aims to describe the impact of cancer on health outcomes in patients with type 2 diabetes and to compare the effectiveness of a multifactorial intervention in diabetes patients with and without cancer.

Methods: The randomized controlled trial Diabetes Care in General Practice (DCGP) included 1381 patients newly diagnosed with type 2 diabetes. Patients were randomized to either six years of structured personal diabetes care or routine care. In a post hoc analysis, we followed patients for 19 years in Danish national registries for the occurrence of diabetes-related outcomes. We used Cox regression models to estimate hazard ratios for outcomes.

Results: At diagnosis 48 patients had cancer, and 243 patients were diagnosed with cancer during follow up. Patients with diabetes and cancer had excess all-cause mortality (HR 3.33; 95%CI 2.72-4.06), as well as an increased incidence of myocardial infarction (HR 1.76; 95%CI 1.29-2.39) and any diabetes-related outcome (HR 1.36; 95%CI 1.07-1.71). The intervention reduced the risk of both these endpoints in patients without cancer. Furthermore, there was no statistically significant difference in the effectiveness of the intervention among patients with and without cancer.

Conclusions: Diabetes patients with cancer had an increased risk of myocardial infarction and any diabetes-related outcome. The observed positive effect of structured personal diabetes care on clinical outcomes did not differ between patients with and without cancer. Attention to and prevention of diabetes complications in patients with both type 2 diabetes and cancer is warranted.

Trial Registration: ClinicalTrials.gov NCT01074762 (February 24, 2010).

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References

Earle C, Burstein H, Winer E, Weeks J . Quality of non-breast cancer health maintenance among elderly breast cancer survivors. J Clin Oncol. 2003; 21(8):1447-51. DOI: 10.1200/JCO.2003.03.060. View

Earle C, Neville B . Under use of necessary care among cancer survivors. Cancer. 2004; 101(8):1712-9. DOI: 10.1002/cncr.20560. View

Pedersen C, Gotzsche H, Moller J, Mortensen P . The Danish Civil Registration System. A cohort of eight million persons. Dan Med Bull. 2006; 53(4):441-9. View

Sabatino S, Coates R, Uhler R, Pollack L, Alley L, Zauderer L . Provider counseling about health behaviors among cancer survivors in the United States. J Clin Oncol. 2007; 25(15):2100-6. DOI: 10.1200/JCO.2006.06.6340. View

Kerr E, Heisler M, Krein S, Kabeto M, Langa K, Weir D . Beyond comorbidity counts: how do comorbidity type and severity influence diabetes patients' treatment priorities and self-management?. J Gen Intern Med. 2007; 22(12):1635-40. PMC: 2219819. DOI: 10.1007/s11606-007-0313-2. View

Keating N, Zaslavsky A, Herrinton L, Selby J, Wolf R, Ayanian J . Quality of diabetes care among cancer survivors with diabetes. Med Care. 2007; 45(9):869-75. DOI: 10.1097/MLR.0b013e31806728e9. View

Barone B, Yeh H, Snyder C, Peairs K, Stein K, Derr R . Long-term all-cause mortality in cancer patients with preexisting diabetes mellitus: a systematic review and meta-analysis. JAMA. 2008; 300(23):2754-64. PMC: 3093051. DOI: 10.1001/jama.2008.824. View

Chiao E, Nambi P, Naik A . The impact of diabetes process and outcome quality measures on overall survival in patients with co-morbid colorectal cancer. J Cancer Surviv. 2010; 4(4):381-7. PMC: 3175493. DOI: 10.1007/s11764-010-0141-y. View

Bayliss E, Blatchford P, Newcomer S, Steiner J, Fairclough D . The effect of incident cancer, depression and pulmonary disease exacerbations on type 2 diabetes control. J Gen Intern Med. 2011; 26(6):575-81. PMC: 3101974. DOI: 10.1007/s11606-010-1600-x. View

10.

Morris R, Sanders C, Kennedy A, Rogers A . Shifting priorities in multimorbidity: a longitudinal qualitative study of patient's prioritization of multiple conditions. Chronic Illn. 2011; 7(2):147-61. DOI: 10.1177/1742395310393365. View

11.

Johnson J, Bowker S, Richardson K, Marra C . Time-varying incidence of cancer after the onset of type 2 diabetes: evidence of potential detection bias. Diabetologia. 2011; 54(9):2263-71. DOI: 10.1007/s00125-011-2242-1. View

12.

Helweg-Larsen K . The Danish Register of Causes of Death. Scand J Public Health. 2011; 39(7 Suppl):26-9. DOI: 10.1177/1403494811399958. View

13.

Lynge E, Sandegaard J, Rebolj M . The Danish National Patient Register. Scand J Public Health. 2011; 39(7 Suppl):30-3. DOI: 10.1177/1403494811401482. View

14.

Gjerstorff M . The Danish Cancer Registry. Scand J Public Health. 2011; 39(7 Suppl):42-5. DOI: 10.1177/1403494810393562. View

15.

Liu X, Ji J, Sundquist K, Sundquist J, Hemminki K . Mortality causes in cancer patients with type 2 diabetes mellitus. Eur J Cancer Prev. 2011; 21(3):300-6. DOI: 10.1097/CEJ.0b013e32834c9cd9. View

16.

Renehan A, Yeh H, Johnson J, Wild S, Gale E, Moller H . Diabetes and cancer (2): evaluating the impact of diabetes on mortality in patients with cancer. Diabetologia. 2012; 55(6):1619-32. DOI: 10.1007/s00125-012-2526-0. View

17.

Onitilo A, Engel J, Glurich I, Stankowski R, Williams G, Doi S . Diabetes and cancer I: risk, survival, and implications for screening. Cancer Causes Control. 2012; 23(6):967-81. PMC: 4138802. DOI: 10.1007/s10552-012-9972-3. View

18.

Soltow Hershey D, Tipton J, Given B, Davis E . Perceived impact of cancer treatment on diabetes self-management. Diabetes Educ. 2012; 38(6):779-90. DOI: 10.1177/0145721712458835. View

19.

Snyder C, Frick K, Herbert R, Blackford A, Neville B, Wolff A . Quality of care for comorbid conditions during the transition to survivorship: differences between cancer survivors and noncancer controls. J Clin Oncol. 2013; 31(9):1140-8. PMC: 3595422. DOI: 10.1200/JCO.2012.43.0272. View

20.

Hansen L, Siersma V, Beck-Nielsen H, Olivarius N . Structured personal care of type 2 diabetes: a 19 year follow-up of the study Diabetes Care in General Practice (DCGP). Diabetologia. 2013; 56(6):1243-53. DOI: 10.1007/s00125-013-2893-1. View