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Weight Change after Cancer Diagnosis and Risk of Diabetes Mellitus: A Population-Based Nationwide Study
Hye Yeon Koo, Kyungdo Han, Mi Hee Cho, Wonyoung Jung, Jinhyung Jung, In Young Cho, Dong Wook Shin
Received June 25, 2024  Accepted August 28, 2024  Published online August 29, 2024  
DOI: https://doi.org/10.4143/crt.2024.586    [Epub ahead of print]
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Cancer survivors are at increased risk of diabetes mellitus (DM). Additionally, the prevalence of obesity, which is also a risk factor for DM, is increasing in cancer survivors. We investigated the associations between weight change after cancer diagnosis and DM risk.
Materials and Methods
This retrospective cohort study used data from the Korean National Health Insurance Service. Participants who were newly diagnosed with cancer from 2010 to 2016 and received national health screening before and after diagnosis were included and followed until 2019. Weight change status after cancer diagnosis was categorized into four groups: sustained normal weight, obese to normal weight, normal weight to obese, or sustained obese. Cox proportional hazard analyses were performed to examine associations between weight change and DM.
Results
The study population comprised 264,250 cancer survivors. DM risk was highest in sustained obese (adjusted hazard ratios [aHR], 2.17; 95% confidence interval [CI], 2.08 to 2.26), followed by normal weight to obese (aHR, 1.66; 95% CI, 1.54 to 1.79), obese to normal weight (aHR, 1.29; 95% CI, 1.21 to 1.39), and then sustained normal weight group (reference). In subgroup analyses according to cancer type, most cancers showed the highest risks in sustained obese group.
Conclusion
Obesity at any time point was related to increased DM risk, presenting the highest risk in cancer survivors with sustained obesity. Survivors who changed from obese to normal weight had lower risk than survivors with sustained obesity. Survivors who changed from normal weight to obese showed increased risk compared to those who sustained normal weight. Our finding supports the significance of weight management among cancer survivors.

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  • Effects of smoking behavior change on diabetes incidence after cancer development: A nationwide cohort study
    MI Hee Cho, Jinhyung Jung, Hye Yeon Koo, Wonyoung Jung, Kyungdo Han, In Young Cho, Dong Wook Shin
    Diabetes & Metabolism.2025; 51(1): 101604.     CrossRef
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  • 48 Download
  • 1 Crossref
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Hematologic malignancy
Long-term Psychiatric and Endocrine Complications Following Hematopoietic Stem Cell Transplantation in Hematologic Disease in Korea: A Nation-Wide Cohort Study
Min Ji Jeon, Eunjin Noh, Seok Joo Moon, Eun Sang Yu, Chul Won Choi, Dae Sik Kim, Eun Joo Kang
Cancer Res Treat. 2024;56(4):1262-1269.   Published online May 9, 2024
DOI: https://doi.org/10.4143/crt.2024.047
AbstractAbstract PDFPubReaderePub
Purpose
Numerous patients experience long-term complications after hematopoietic stem cell transplantation (HSCT). This study aimed to identify the frequency and risk factors for psychiatric and endocrine complications following HSCT through big data analyses.
Materials and Methods
We established a cohort of patients with hematologic disease who underwent HSCT in Korea between 2010 and 2012 using the Health Insurance Review & Assessment Service data. A total of 3,636 patients were identified, and insurance claims were tracked using psychiatric and endocrine diagnostic International Classification of Diseases, 10th Revision codes for the ensuing decade. We identified the incidence rates of long-term complications based on the baseline disease and HSCT type. Prognostic factors for each complication were scrutinized using logistic regression analysis.
Results
A total of 1,879 patients underwent allogeneic HSCT and 1,757 patients received autologous HSCT. Post-HSCT, 506 patients were diagnosed with depression, 465 with anxiety disorders, and 659 with diabetes. The highest incidence of long-term complications occurred within the first year post-HSCT (12.2%), subsequently decreasing over time. Risk factors for depressive disorders after allogeneic HSCT included female sex, a total body irradiation–based conditioning regimen, and cyclosporine. Identified risk factors for diabetes mellitus comprised old age, total body irradiation–based conditioning regimen, and non-antithymocyte globulin protocol. Regarding autologous HSCT, only female sex was identified as a risk factor for depressive disorders, whereas elderly patients and those with multiple myeloma were identified as poor prognostic factors for diabetes mellitus.
Conclusion
The incidence of long-term psychiatric and endocrine complications post-HSCT remains high, and patients with risk factors for these complications require vigilant follow-up.
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Increased Risk of Diabetes after Definitive Radiotherapy in Patients with Indolent Gastroduodenal Lymphoma
Jong Yun Baek, Do Hoon Lim, Dongryul Oh, Heerim Nam, Jae J Kim, Jun Haeng Lee, Byung-Hoon Min, Hyuk Lee
Cancer Res Treat. 2022;54(1):294-300.   Published online April 1, 2021
DOI: https://doi.org/10.4143/crt.2021.073
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to evaluate the effect of radiotherapy (RT) on the risk of diabetes by assessing hemoglobin A1c (HbA1c) levels in patients with gastroduodenal indolent lymphoma.
Materials and Methods
This retrospective study included patients with stage I extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue or follicular lymphoma of the gastroduodenal region who were treated with Helicobacter pylori eradication and/or RT between 2000 and 2019 in our institution. Of total 79 patients with HbA1c test, 17 patients received RT (RT group), while 62 patients did not receive RT (control group). A diabetes-associated event (DAE) was defined as a ≥ 0.5% increase in HbA1c levels from baseline, and diabetes event (DE) were defined as HbA1c level of ≥ 6.5%.
Results
During the median follow-up of 49 months, no local failure occurred after RT and no patients died of lymphoma. The RT group had significantly higher risk for DAEs on univariable analysis (hazard ratio [HR], 4.18; 95% confidence interval [CI], 1.64 to 10.66; p < 0.01) and multivariable analysis (HR, 3.68; 95% CI, 1.42 to 9.56; p=0.01). Further, the DE risk was significantly higher in the RT group than in the control group (HR, 4.32; 95% CI, 1.08 to 17.30; p=0.04) and in patients with increased baseline HbA1c levels (HR, 35.83; 95% CI, 2.80 to 459.19; p=0.01). On multivariable analysis, RT significantly increased the risk of DEs (HR, 4.55; 95% CI, 1.08 to 19.19; p=0.04), even after adjusting baseline HbA1c level (HR, 40.97; 95% CI, 3.06 to 548.01; p=0.01).
Conclusion
Patients who received RT for gastroduodenal indolent lymphoma had an increased risk of diabetes compared to those who did not.

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  • CHARACTERISTICS OF ENDOCRINE COMPONENT OF PANCREAS AFTER ADMINISTRATION OF N-ACETYLCYSTEINE IN THE MODEL OF ACUTE RADIATION-INDUCED PANCREATITIS
    Grigoriy Aleksandrovich Demyashkin, Dali Ibragimovna Ugurchieva, Vladislav Andreevich Yakimenko, Matvey Anatol'evich Vadyukhin
    Ulyanovsk Medico-biological Journal.2024; (2): 166.     CrossRef
  • ASSESSMENT OF THE INFLAMMATORY RESPONSE IN THE PANCREAS AFTER ADMINISTRATION OF N-ACETYL CYSTEINE IN A MODEL OF POST-RADIATION PANCREATITIS
    G.A. Demyashkin, D.A. Atyakshin, D.I. Ugurchieva, V.A. Yakimenko, M.A. Vadyukhin, S.N. Koryakin
    Molekulyarnaya Meditsina (Molecular medicine).2024; : 58.     CrossRef
  • Lactobacillus gasseriCKCC1913 mediated modulation of the gut–liver axis alleviated insulin resistance and liver damage induced by type 2 diabetes
    Shuaiming Jiang, Aijie Liu, Wenyao Ma, Xinlei Liu, Pengfei Luo, Meng Zhan, Xiaoli Zhou, Lihao Chen, Jiachao Zhang
    Food & Function.2023; 14(18): 8504.     CrossRef
  • Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study
    Reynalda Cordova, Vivian Viallon, Emma Fontvieille, Laia Peruchet-Noray, Anna Jansana, Karl-Heinz Wagner, Cecilie Kyrø, Anne Tjønneland, Verena Katzke, Rashmita Bajracharya, Matthias B. Schulze, Giovanna Masala, Sabina Sieri, Salvatore Panico, Fulvio Ricc
    The Lancet Regional Health - Europe.2023; 35: 100771.     CrossRef
  • Risk of Diabetes Mellitus after Radiotherapy for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma
    Joongyo Lee, Hong In Yoon, Jihun Kim, Jaeho Cho, Kyung Hwan Kim, Chang-Ok Suh
    Cancers.2022; 14(17): 4110.     CrossRef
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  • 2 Web of Science
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Diabetes Mellitus Is Associated with Inferior Prognosis in Patients with Chronic Lymphocytic Leukemia: A Propensity Score-Matched Analysis
Rui Gao, Tian-Shuo Man, Jin-Hua Liang, Li Wang, Hua-Yuan Zhu, Wei Wu, Lei Fan, Jian-Yong Li, Tao Yang, Wei Xu
Cancer Res Treat. 2020;52(1):189-206.   Published online July 1, 2019
DOI: https://doi.org/10.4143/crt.2019.122
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Diabetes mellitus (DM) is associated with elevated cancer risk and poor survival outcome in malignancies. The objective of this study was to evaluate the prognostic value of preexisting DM in chronic lymphocytic leukemia (CLL).
Materials and Methods
Six hundred and thirty-three subjects with newly-diagnosed CLL between 2007 and 2016 were recruited. Propensity score-matched method was performed to balance baseline characteristics and eliminate possible bias. Univariate and multivariate Cox regression analyses screened the independent risk indicators for time-to-first-treatment (TTFT) and cancer-specific survival (CSS) of CLL. Receiver operator characteristic curves and the corresponding areas under the curve assessed the predictive accuracy of CLL–International Prognostic Index (IPI) together with DM.
Results
The results showed that 111 patients had pre-existing DM. In the propensity-matched cohort, DM was correlated with inferior TTFT and CSS in CLL patients, and it was an independent prognostic factor for both CSS and TTFT. Pre-diabetics also shared undesirable prognostic outcome compared with patients with no diabetic tendency, and a positive association between longer diabetic duration and poorer prognosis of CLL was identified. DM as one additional point to CLL-IPI had larger area under the curve compared with CLL-IPI alone in CSS prediction and could improve the prognostic capacity of CLL-IPI.
Conclusion
Pre-existing DM was found to be a valuable prognostic predictor and could help predict life expectancy and build refined prognostication models for CLL.

Citations

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  • Molecular Secrets Revealed: How Diabetes may be Paving the Way for Leukemia
    Pouya Goleij, Mohammad Amin Khazeei Tabari, Ahmed Rabie Dahab Ahmed, Leena Mohamed Elamin Mohamed, Ghaida Ahmed Hamed Saleh, Malak Tarig Mohamed Abdu Hassan, Alaa Galal Mohammed Moahmmednoor, Haroon Khan
    Current Treatment Options in Oncology.2024; 25(12): 1563.     CrossRef
  • Causal associations between site-specific cancer and diabetes risk: A two-sample Mendelian randomization study
    Rong Xu, Tingjin Zheng, Chaoqun Ouyang, Xiaoming Ding, Chenjin Ge
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Association between diabetes and acute lymphocytic leukemia, acute myeloid leukemia, non-Hopkin lymphoma, and multiple myeloma
    Ji Zhong Zhao, Yu Cheng Lu, Yan Min Wang, Bo Lian Xiao, Hong Yan Li, Shao Chin Lee, Li Juan Wang
    International Journal of Diabetes in Developing Countries.2022; 42(4): 694.     CrossRef
  • Increased serum level of alpha-2 macroglobulin and its production by B-lymphocytes in chronic lymphocytic leukemia
    Regina Michelis, Lama Milhem, Evleen Galouk, Galia Stemer, Ariel Aviv, Tamar Tadmor, Mona Shehadeh, Lev Shvidel, Masad Barhoum, Andrei Braester
    Frontiers in Immunology.2022;[Epub]     CrossRef
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  • 4 Web of Science
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Association between Metformin Use and Survival in Nonmetastatic Rectal Cancer Treated with a Curative Resection: A Nationwide Population Study
Young-Jun Ki, Hyo Jeong Kim, Mi-Sook Kim, Chan Mi Park, Min Jung Ko, Young Seok Seo, Sun Mi Moon, Jin A Choi
Cancer Res Treat. 2017;49(1):29-36.   Published online July 4, 2016
DOI: https://doi.org/10.4143/crt.2016.128
AbstractAbstract PDFPubReaderePub
Purpose
Metformin is associated with an anticancer effect. However, the effects of metformin in rectal cancer are controversial. This study investigated the impact of metformin on the survival of patients with diabetes mellitus and nonmetastatic rectal cancer who underwent curative surgery.
Materials and Methods
The database was provided by the Korea Center Cancer Registry and National Health Insurance Service of the Republic of Korea. A cohort of patients with newly diagnosed rectal cancer between 2005 and 2011 was identified. Drug exposure was defined as receiving the oral hypoglycemic agent for at least 90 days over the period from 6 months before the initial diagnosis of rectal cancer to the last follow-up.
Results
A total of 4,503 patients were prescribed oral hypoglycemic agents and classified as the diabetic group, of which 3,694 patients received metformin for at least 90 days. Unadjusted analyses showed a significantly higher overall survival (hazard ratio, 0.596; 95% confidence interval, 0.506 to 0.702) and rectal cancer-specific survival (hazard ratio, 0.621; 95% confidence interval, 0.507 to 0.760) in the metformin group than in the nonmetformin group. The adjusted overall survival (hazard ratio, 0.631; 95% confidence interval, 0.527 to 0.755) and cancer-specific survival (hazard ratio, 0.598; 95% confidence interval, 0.479 to 0.746) in the group with a medication possession ratio of 80% or greater was significantly higher than in the group with a medication possession ratio of less than 80%.
Conclusion
Metformin use is associated with overall and cancer-specific survival in diabetic patients with a nonmetastatic rectal cancer treated with a curative resection.

Citations

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  • Metformin Does not Affect Outcomes in Patients With Locally Advanced Rectal Cancer Treated With Neoadjuvant Therapy and Resection
    Swati Sonal, Chloe Boudreau, Hiroko Kunitake, Robert N. Goldstone, Grace C. Lee, Christy E. Cauley, Liliana G. Bordeianou, Todd D. Francone, Rocco Ricciardi, David L. Berger
    The American Surgeon™.2024; 90(4): 858.     CrossRef
  • View on Metformin: Antidiabetic and Pleiotropic Effects, Pharmacokinetics, Side Effects, and Sex-Related Differences
    Guglielmina Froldi
    Pharmaceuticals.2024; 17(4): 478.     CrossRef
  • Type II diabetes and metformin use does not affect colorectal cancer prognosis
    Mehrnoosh Shahrivar, Caroline E. Dietrich, Bengt Glimelius, Deborah Saraste, Anna Martling, Christian Buchli, Caroline Nordenvall
    International Journal of Cancer.2024;[Epub]     CrossRef
  • Survival benefit of metformin use according to cancer diagnosis in diabetic patients with metabolic syndrome
    Ji Soo Park, Soo Jin Moon, Hyung Seok Park, Sang-Hoon Cho
    Preventive Medicine Reports.2024; 48: 102928.     CrossRef
  • Metformin combined with local irradiation provokes abscopal effects in a murine rectal cancer model
    Mineyuki Tojo, Hideyo Miyato, Koji Koinuma, Hisanaga Horie, Hidenori Tsukui, Yuki Kimura, Yuki Kaneko, Hideyuki Ohzawa, Hironori Yamaguchi, Kotaro Yoshimura, Alan Kawarai Lefor, Naohiro Sata, Joji Kitayama
    Scientific Reports.2022;[Epub]     CrossRef
  • Clinicopathological Characteristics and Overall 5-Year Survival of Colorectal Cancer: A Retrospective Study
    Rahaf Almuhanna, Fatma Al-Thoubaity, Khadijah Almalki, Nada Algarni, Renad Hamad, Toleen Makhtoum
    Medical Sciences.2022; 10(3): 42.     CrossRef
  • Prognostic value of metformin in cancers: An updated meta-analysis based on 80 cohort studies
    Jing Yang, Hang Yang, Ling Cao, Yuzhen Yin, Ying Shen, Wei Zhu
    Medicine.2022; 101(49): e31799.     CrossRef
  • Potential intrinsic subtype dependence on the association between metformin use and survival in surgically resected breast cancer: a Korean national population-based study
    Byoung Hyuck Kim, Moon-June Cho, Jeanny Kwon
    International Journal of Clinical Oncology.2021; 26(11): 2004.     CrossRef
  • Suppressive effects of metformin on colorectal adenoma incidence and malignant progression
    Min Deng, Siqin Lei, Dongdong Huang, Hui Wang, Shuli Xia, Enping Xu, Yihua Wu, Honghe Zhang
    Pathology - Research and Practice.2020; 216(2): 152775.     CrossRef
  • Effect of metformin on the mortality of colorectal cancer patients with T2DM: meta-analysis of sex differences
    Yunzi Wang, Jingping Xiao, Yuanyu Zhao, Shijuan Du, Jiang Du
    International Journal of Colorectal Disease.2020; 35(5): 827.     CrossRef
  • Postdiagnostic metformin use and survival of patients with colorectal cancer: A Nationwide cohort study
    Wen‐Kuan Huang, Shu‐Hao Chang, Hung‐Chih Hsu, Wen‐Chi Chou, Tsai‐Sheng Yang, Jen‐Shi Chen, John Wen‐Cheng Chang, Yung‐Chang Lin, Chang‐Fu Kuo, Lai‐Chu See
    International Journal of Cancer.2020; 147(7): 1904.     CrossRef
  • Metformin and colorectal cancer: a systematic review, meta-analysis and meta-regression
    Cheng-Ann Winston Ng, Amy Aimei Jiang, Emma Min Shuen Toh, Cheng Han Ng, Zhi Hao Ong, Siyu Peng, Hui Yu Tham, Raghav Sundar, Choon Seng Chong, Chin Meng Khoo
    International Journal of Colorectal Disease.2020; 35(8): 1501.     CrossRef
  • Metformin changes the immune microenvironment of colorectal cancer in patients with type 2 diabetes mellitus
    Akira Saito, Joji Kitayama, Hisanaga Horie, Koji Koinuma, Hideyuki Ohzawa, Hironori Yamaguchi, Hiroshi Kawahira, Toshiki Mimura, Alan Kawarai Lefor, Naohiro Sata
    Cancer Science.2020; 111(11): 4012.     CrossRef
  • Patterns of Rectal Cancer Radiotherapy Adopting Evidence-Based Medicine: An Analysis of the National Database from 2005 to 2016
    Hae Jin Park, Sanghyun Cho, Yoon Kim
    Cancer Research and Treatment.2018; 50(3): 975.     CrossRef
  • UEG Week 2018 Poster Presentations

    United European Gastroenterology Journal.2018;[Epub]     CrossRef
  • 11,860 View
  • 307 Download
  • 18 Web of Science
  • 15 Crossref
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Poor Preoperative Glycemic Control Is Associated with Dismal Prognosis after Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Korean Multicenter Study
Sung Gu Kang, Eu Chang Hwang, Seung Il Jung, Ho Song Yu, Ho Seok Chung, Taek Won Kang, Dong Deuk Kwon, Jun Eul Hwang, Jun Seok Kim, Joon Hwa Noh, Jae Hyung You, Myung Ki Kim, Tae Hoon Oh, Ill Young Seo, Seung Baik, Chul-Sung Kim, Seok Ho Kang, Jun Cheon
Cancer Res Treat. 2016;48(4):1293-1301.   Published online March 23, 2016
DOI: https://doi.org/10.4143/crt.2016.021
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to evaluate the effect of diabetes mellitus (DM) and preoperative glycemic control on prognosis in Korean patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). Materials and Methods A total of 566 patients who underwent RNU at six institutions between 2004 and 2014 were reviewed retrospectively. Kaplan-Meier and Cox regression analyses were performed to assess the association between DM, preoperative glycemic control, and recurrence-free, cancer-specific, and overall survival.
Results
The median follow-up period was 33.8 months (interquartile range, 41.4 months). A total of 135 patients (23.8%) had DM and 67 patients (11.8%) had poor preoperative glycemic control. Patients with poor preoperative glycemic control had significantly shorter median recurrence-free, cancer-specific, and overall survival than patients with good preoperative glycemic control and non-diabetics (all, p=0.001). In multivariable Cox regression analysis, DM with poor preoperative glycemic control showed association with worse recurrence-free survival (hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.31 to 3.90; p=0.003), cancer-specific survival (HR, 2.96; 95% CI, 1.80 to 4.87; p=0.001), and overall survival (HR, 2.13; 95% CI, 1.40 to 3.22; p=0.001). Conclusion Diabetic UTUC patients with poor preoperative glycemic control had significantly worse oncologic outcomes than diabetic UTUC patients with good preoperative glycemic control and non-diabetics. Further investigation is needed to elucidate the exact mechanism underlying the impact of glycemic control on UTUC treatment outcome.

Citations

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  • Identifying ways to improve diabetes management during cancer treatments (INDICATE): protocol for a qualitative interview study with patients and clinicians
    Laura Ashley, Saifuddin Kassim, Ian Kellar, Lisa Kidd, Frances Mair, Mike Matthews, Mollie Price, Daniel Swinson, Johanna Taylor, Galina Velikova, Jonathan Wadsley
    BMJ Open.2022; 12(2): e060402.     CrossRef
  • Annular-shaped stenosis in the ureter: Caution should be taken
    Jie Ming, Yue Wang, Ziliang Su, Chunyang Wang
    Urologic Oncology: Seminars and Original Investigations.2022; 40(6): 274.e7.     CrossRef
  • Glycosylated haemoglobin and prognosis in 10,536 people with cancer and pre-existing diabetes: a meta-analysis with dose-response analysis
    Suping Ling, Michael Sweeting, Francesco Zaccardi, David Adlam, Umesh T. Kadam
    BMC Cancer.2022;[Epub]     CrossRef
  • Malnutrition management of hospitalized patients with diabetes/hyperglycemia and cancer cachexia
    Rosa Burgos Peláez, José Pablo Suárez Llanos, Jose Manuel García Almeida, Pilar Matía Martín, Samara Palma Milla, Alejandro Sanz Paris, Ana Zugasti Murillo, Ana Artero-Fullana, Alfonso Calañas Continente, M.ª Jesús Chinchetru, Katherine García Malpartida,
    Nutrición Hospitalaria.2022;[Epub]     CrossRef
  • The Impact of Diabetes on the Prognosis of Upper Tract Urothelial Carcinoma After Radical Nephroureterectomy: A Systematic Review and Meta-Analysis
    Xiaoshuai Gao, Liang Zhou, Jianzhong Ai, Wei Wang, Xingpeng Di, Liao Peng, Banghua Liao, Xi Jin, Hong Li, Kunjie Wang
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • The Prognostic Value of Lymphovascular Invasion in Patients With Upper Tract Urinary Carcinoma After Surgery: An Updated Systematic Review and Meta-Analysis
    Lijin Zhang, Bin Wu, Zhenlei Zha, Hu Zhao, Jun Yuan, Yejun Feng
    Frontiers in Oncology.2020;[Epub]     CrossRef
  • The impact of preoperative glycated hemoglobin levels on outcomes in oral squamous cell carcinoma
    Ze Yun Tay, Huang‐Kai Kao, Kuang‐Hsu Lien, Shao‐Yu Hung, Yenlin Huang, Ngan‐Ming Tsang, Kai‐Ping Chang
    Oral Diseases.2020; 26(7): 1449.     CrossRef
  • 10,800 View
  • 120 Download
  • 8 Web of Science
  • 7 Crossref
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A Pilot Study Evaluating Steroid-Induced Diabetes after Antiemetic Dexamethasone Therapy in Chemotherapy-Treated Cancer Patients
Yusook Jeong, Hye Sook Han, Hyo Duk Lee, Jiyoul Yang, Jiwon Jeong, Moon Ki Choi, Jihyun Kwon, Hyun-Jung Jeon, Tae-Keun Oh, Ki Hyeong Lee, Seung Taik Kim
Cancer Res Treat. 2016;48(4):1429-1437.   Published online February 29, 2016
DOI: https://doi.org/10.4143/crt.2015.464
AbstractAbstract PDFPubReaderePub
Purpose
Dexamethasone is a mainstay antiemetic regimen for the prevention of chemotherapy-induced nausea and vomiting. The aim of this pilot study was to assess the incidence of and factors associated with steroid-induced diabetes in cancer patients receiving chemotherapy with dexamethasone as an antiemetic.
Materials and Methods
Non-diabetic patients with newly diagnosed gastrointestinal cancer who received at least three cycles of highly or moderately emetogenic chemotherapy with dexamethasone as an antiemetic were enrolled. Fasting plasma glucose levels, 2-hour postprandial glucose levels, and hemoglobin A1C tests for the diagnosis of diabetes were performed before chemotherapy and at 3 and 6 months after the start of chemotherapy. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an index for measurement of insulin resistance, defined as a HOMA-IR ≥ 2.5.
Results
Between January 2012 and November 2013, 101 patients with no history of diabetes underwent laboratory tests for assessment of eligibility; 77 of these patients were included in the analysis. Forty-five patients (58.4%) were insulin resistant and 17 (22.1%) developed steroid-induced diabetes at 3 or 6 months after the first chemotherapy, which included dexamethasone as an antiemetic. Multivariate analysis showed significant association of the incidence of steroid-induced diabetes with the cumulative dose of dexamethasone (p=0.049).
Conclusion
We suggest that development of steroid-induced diabetes after antiemetic dexamethasone therapy occurs in approximately 20% of non-diabetic cancer patients; this is particularly significant for patients receiving high doses of dexamethasone.

Citations

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    Yuki Mikame, Yasunari Okuda, Makoto Shinada, Takahiro Saito, Naoto Kobayashi, Takako Yamashita, Masato Nakata, Daichi Arai, Mika Ohira, Izumi Tamura, Yasushi Imai
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  • Dexamethasone-Free Antiemetic Prophylaxis for Highly Emetogenic Chemotherapy: A Double-Blind, Phase III Randomized Controlled Trial (CINV POD study)
    Venkatraman Radhakrishnan, Kritthivasan Venkatakrishnan, Jayachandran Perumal Kalaiyarasi, Gangothri Selvarajan, Nizamudin Mahaboobasha, Paulson Vijaykumar Victor, Malarvizhi Anbazhagan, Deyva Manohari Sivanandam, Swaminathan Rajaraman
    JCO Global Oncology.2024;[Epub]     CrossRef
  • Glucocorticoid-Induced Hyperglycemia: A Neglected Problem
    Jung-Hwan Cho, Sunghwan Suh
    Endocrinology and Metabolism.2024; 39(2): 222.     CrossRef
  • The impact of surgery and oncological treatment on risk of type 2 diabetes onset in patients with colorectal cancer: nationwide cohort study in Denmark
    Caroline Krag, Maria Saur Svane, Sten Madsbad, Susanne Boel Graversen, Jesper Frank Christensen, Thorkild IA Sørensen, Louise Lang Lehrskov, Tinne Laurberg
    eLife.2024;[Epub]     CrossRef
  • Efficacy and safety of dexamethasone sparing for the prevention of nausea and vomiting associated with highly emetogenic risk antineoplastic agents: a systematic review and meta-analysis of the Clinical Practice Guidelines for Antiemesis 2023 from the Jap
    Ayako Yokomizo, Kazuhisa Nakashima, Arisa Iba, Kenji Okita, Makoto Wada, Keiko Iino, Tatsuo Akechi, Hirotoshi Iihara, Chiyo K. Imamura, Ayako Okuyama, Keiko Ozawa, Yong-Il Kim, Hidenori Sasaki, Eriko Satomi, Masayuki Takeda, Ryuhei Tanaka, Takako Eguchi N
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