University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198, USA.
University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198, USA.
Eur J Oncol Nurs. 2020 Oct;48:101797. doi: 10.1016/j.ejon.2020.101797. Epub 2020 Jul 22.
Glycemic variability is associated with risks for adverse events in patients with cancer. Several studies have evaluated the presence and impact of hyperglycemia and/or hypoglycemia in patients with cancer; however, few studies have evaluated glycemic variability. The purpose of this integrative review of studies in patients with gastrointestinal cancers was to investigate the presence and methods of reporting glycemic variability during and following treatments.
A comprehensive review of the literature was conducted. PubMed, CINAHL, EMBASE, and Cochrane databases were searched for publications between 1/1/1969 and 7/24/2019. Studies of patients with gastrointestinal cancer following surgery, during treatment, and <5 years following treatment were included and evaluated by cancer type and method of glucose and glycemic variability measurement.
Among 1526 patients with gastrointestinal cancer across 19 studies, gastric and pancreatic cancers were most prevalent. Timing of glucose testing and methods of analyzing glycemic variability varied. Most analyses used the standard deviation or interquartile range. Glycemic variability was more prevalent among patients with Type 2 Diabetes and among those with pancreatic cancer. In some patients glycemic variability remained notable > one year following surgery despite improvements in glycemic control.
Patients with gastrointestinal cancer experience glycemic variability during and up to one year following treatment. There was heterogeneity in methods related to timing of testing and reporting glycemic variability among the 19 studies in this review. Future investigations need to identify the presence and define the methods of measuring glycemic variability in patients with gastrointestinal cancer.
血糖变异性与癌症患者不良事件的风险相关。有几项研究评估了癌症患者的高血糖和/或低血糖的存在和影响；然而，很少有研究评估血糖变异性。本项针对胃肠道癌症患者的研究的综合回顾旨在调查治疗期间和治疗后血糖变异性的存在和报告方法。
进行了全面的文献回顾。在 1969 年 1 月 1 日至 2019 年 7 月 24 日期间，检索了 PubMed、CINAHL、EMBASE 和 Cochrane 数据库中的出版物。纳入了接受手术治疗、治疗期间和治疗后 <5 年的胃肠道癌症患者的研究，并根据癌症类型和葡萄糖及血糖变异性测量方法进行评估。
在 19 项研究的 1526 名胃肠道癌症患者中，胃癌和胰腺癌最为常见。葡萄糖检测的时间和分析血糖变异性的方法存在差异。大多数分析使用标准差或四分位距。2 型糖尿病患者和胰腺癌患者的血糖变异性更为常见。在一些患者中，尽管血糖控制得到改善，但术后一年仍存在显著的血糖变异性。
胃肠道癌症患者在治疗期间和治疗后一年期间经历血糖变异性。在本综述中的 19 项研究中，与测试时间和报告血糖变异性相关的方法存在异质性。未来的研究需要确定胃肠道癌症患者血糖变异性的存在并定义其测量方法。
