Manders, M. (Marjolein) (2016) Diabetes care after cancer diagnosis in patients with type 2 diabetes and colorectal- or breast cancer treated with curative intent. thesis, Medicine.
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Abstract
Abstract Objective: Adequate glycemic regulation in patients with type 2 diabetes has a positive effect on a patient’s cardiovascular risk, and possibly also concerning cancer risk and mortality risk. Cancer diagnosis could have an impact on the diabetes care, therefore this study explored the effects of cancer diagnoses on HbA1c, systolic blood pressure and cholesterol/HDL ratio in patients with type 2 diabetes mellitus (T2DM), with colorectal and breast cancer, treated with curative intent. Methods: For this study the diabetes specific Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) cohort was linked with the Dutch Cancer Registration. Patients were included when diagnosed with T2DM treated in primary care and when subsequently diagnosed with primary breast or colorectal carcinoma treated with curative intent between 1999 and 2012. The control group consists of patients with T2DM, without cancer. Patients were excluded when not treated with curative intent and without one year of participating in the ZODIAC study prior to the cancer diagnosis. Information on HbA1c, cholesterol/HDL lipids, blood pressure, diabetic medication use, cancer and cancer treatment was collected. Mixed model analyses and generalized linear model were used for analysing the data. Results: The colorectal group consisted of 292 patients with colorectal cancer and 23,724 patients without cancer. The breast cancer group consisted of 256 patients with breast cancer and 12,145 female control patients. Patients with colorectal cancer had a significantly higher estimated mean HbA1c (7.00 %, CI; 6.81-7.16) compared to controls (6.81%, CI; 6.79-6.83), at two years after cancer diagnosis, p= 0.048. The mean HbA1c in patients with breast cancer was not significantly different from patients without cancer; 6.96 % (CI; 6.79-7.12) vs. 6.81 % (CI; 6.79-6.83), p=0.061. The target HbA1c was reached less frequently in both colorectal and breast cancer patients, compared to the control patients. The systolic blood pressure and cholesterol/HDL ratio were not significantly different between the cancer and control groups two years after cancer diagnose. The type of cancer treatment did not affect glycemic control. Conclusions: This study showed that the glycemic control was slightly worse after cancer diagnosis in cancer patients, especially in colorectal cancer patients, compared to patients without cancer. As the HbA1c was slightly higher and less cancer patients reached the HbA1c target of <7%.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultary supervisor: and Denig, Prof. dr. P. |
| Supervisor name: | Second supervisor: and Schrijnders, Drs. D. and Location research: Diabetes Centre, Isala Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:40 |
| Last Modified: | 25 Jun 2020 10:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/186 |
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