Short-term adverse effects of anticancer drugs in patients with type 2 diabetes

Abstract

The short-term adverse effects of anticancer drugs (AD) in patients with type 2 diabetes (T2D) are poorly studied and their management still represents an important challenge for clinicians. We carried out a retrospective single-center study in 168 patients with T2D and cancer, evaluating both the short-term effects of first-line AD on glycemic control and chronic diabetes complications. Average glycated hemoglobin significantly increased after AD compared to values before treatment (7.5 vs. 7.1%, p < 0.005). In 46.4% of patients, diabetes therapy had to be potentiated, in most cases (82.1%) by shifting to insulin. The use of alkylating agents and high-dose glucocorticoids predicted the need to potentiate diabetes therapy. After AD transaminase values significantly increased, whereas the estimated glomerular filtration rate decreased (in 12.5% <60 mL/min). Kinase inhibitors significantly increased the risk of microalbuminuria onset or progression. The present study provides a real-life information on the effects of different AD on the management of patients with T2D affected by several types of cancer.

Keywords:

• Cancer
• Anticancer treatment
• Diabetes
• Diabetes and Cancer
• Metabolic control
• Chronic complications

Acknowledgments

The authors thank Prof. Giuliana Arcidiacono, English and Anglo-American language PhD. University of Catania, for the language revision of the manuscript.

Conflict of interest

No potential conflict of interest was reported by the authors.

Ethics approval

All procedures performed in this study were conducted in accordance with the ethical standards of the Helsinki declaration and its later amendments. The ethical committee approval is not required in our institution for retrospective studies anonymously analyzed. For this type of study formal consent is not required

Note on contributors

Agostino Milluzzo has a MD degree and he is specialist in Endocrinology.

Andrea Tumminia has a MD degree and a Ph.D. in Translational Biomedicine, he is specialist in Endocrinology.

Veronica Vella has a MD degree and a Ph.D. in Molecular Basis of Hormone Action. She is specialist in Endocrinology and currently assistant professor in Endocrinology at the University of Catania, Italy.

Fiorenza Gianì has a master degree in Biology.

Livia Manzella has a MD degree and a Ph.D. in Immunopharmacology. She is currently assistant professor in Clinical Pathology at the University of Catania, Italy.

Lucia Frittitta has a MD degree and a Ph.D. in Endocrinological and Metabolic Sciences. She is a full professor in Nutrition at the University of Catania, Italy.

Antonino Belfiore has a MD degree and a PhD in Endocrine and Metabolic Sciences. He is specialist in Endocrinology and in Nuclear Medicine, currently full professor in Endocrinology at the University of Catania and head of the Endocrine Unit at the University of Catania, Italy.

Riccardo Vigneri has a MD degree, he is specialist in Endocrinology and in Nuclear Medicine. He is full professor in Endocrinology and currently emeritus professor in Endocrinology at the University of Catania, Italy.

Laura Sciacca has a MD degree and a Ph.D. in Molecular Basis of Hormone Action. She is specialist in Endocrinology and currently associate professor in Endocrinology at the University of Catania, Italy.

Additional information

Funding

Italian Association for Cancer Research (AIRC) IG 19897 to R.V. and IG 19242 to A.B.