Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Med Oncol. 2013;30(3):687. doi: 10.1007/s12032-013-0687-4. Epub 2013 Aug 8.
Patients with cancer frequently show glucose intolerance. This study is to estimate the status of total diabetes and prediabetes in breast cancer patients after systemic treatment through an oral glucose tolerance test (OGTT) in China. All the 119 breast cancer patients more than 3 months after systemic treatment with surgery and chemotherapy participated in the study. All the patients without the diagnosis of diabetes underwent OGTT, and fasting and 2-h glucose levels were measured to identify undiagnosed diabetes and prediabetes. Previously diagnosed diabetes were determined on the self-report and the medical record. Of the 119 breast cancer patients, with the median age of 50.1 years and the mean age of about 48 years when they were initially diagnosed with breast cancer, which showed the similar characters of China and Asia breast cancer patients, the overall incidences of total diabetes and prediabetes were 21.8 and 43.7 %, respectively. About 80 % of the diabetes were previously undiagnosed. About 80.0 % of the cases of undiagnosed diabetes and prediabetes met the criteria for elevated 2-h plasma glucose levels through OGTT but not the criteria for elevated fasting glucose levels. Our study firstly documents high incidences of previously undiagnosed diabetes and prediabetes in breast cancer patients during follow-up after systemic treatment through OGTT, indicating that greater diabetes screening, especially through OGTT, prevention, and treatment strategies among breast cancer patients, after systemic treatment for these patients is needed.
癌症患者常伴有葡萄糖耐量异常。本研究旨在通过口服葡萄糖耐量试验（OGTT）评估中国乳腺癌患者全身治疗后总体糖尿病和糖尿病前期的状况。所有 119 例全身治疗（包括手术和化疗）后超过 3 个月的乳腺癌患者均参与了本研究。所有未被诊断为糖尿病的患者均进行 OGTT，检测空腹和 2 小时血糖以明确是否存在未诊断的糖尿病和糖尿病前期。既往诊断的糖尿病依据患者自我报告和病历确定。在 119 例乳腺癌患者中，中位年龄为 50.1 岁，乳腺癌初始诊断时的平均年龄约为 48 岁，这与中国和亚洲乳腺癌患者的特征相似，总体糖尿病和糖尿病前期的发生率分别为 21.8%和 43.7%。约 80%的糖尿病患者此前未被诊断。通过 OGTT，约 80.0%的未诊断糖尿病和糖尿病前期患者符合 2 小时血浆葡萄糖升高的标准，但不符合空腹血糖升高的标准。本研究首次通过 OGTT 证实，在全身治疗后随访期间，乳腺癌患者中存在大量先前未被诊断的糖尿病和糖尿病前期，这表明在这些患者接受全身治疗后，需要进行更多的糖尿病筛查，尤其是通过 OGTT 进行筛查，同时还需要制定预防和治疗策略。
