Rao Suresh, Prasad Krishna, Abraham Soniya, George Thomas, Chandran Supreeth Kakkaje, Baliga Manjeshwar Shrinath
Department of Radiation Oncology, Mangalore Institute of Oncology, Mangalore, Karnataka, India.
Department of Medical Oncology, Mangalore Institute of Oncology, Mangalore, Karnataka, India.
South Asian J Cancer. 2020 Jul;9(3):130-135. doi: 10.1055/s-0041-1723104. Epub 2021 Mar 19.
Development of cancer chemotherapy treatment-induced hyperglycemia/ diabetes (secondary diabetes) is a major problem and has never been reported from India. The present study was planned to ascertain this in women undergoing curative chemotherapy for their breast cancer. This was a retrospective chart-based study and was conducted in a cancer specialty hospital. The information on women who were nondiabetic at the start of the treatment was collected from the files. Details on cancer diagnosis, domicile, body mass index (BMI), type of diet, marital status, number of children, and previous history of diabetes if any were considered. The blood glucose levels before surgery and after the completion of radiotherapy were considered. World Health Organization (WHO) guidelines for diabetes were considered. The data were subjected to frequency and percentage and analyzed using Chi-square test. Association between the demographic details and development of Hyperglycemia or secondary diabetes or prediabetes was done using the Pearson's correlation analysis. < 0.05 was considered as statistically significant. A total of 474 cases were included in accordance with the inclusion criteria. The results indicated that by the end of the radiation treatment, 24.89% were prediabetic, 10.97% were diabetic after being in prediabetic stage, 8.22% became diabetic without going through a prediabetic stage, and that 55.91% did not develop either prediabetic or diabetic condition. Analysis of development of secondary diabetes and prediabetes with BMI ( < 0.0001) and age ( < 0.024) showed a strong correlation and was significant. To the best of the authors' knowledge, this is the first study from India, and the results indicate that the development of secondary diabetes in women undergoing curative chemotherapy is high. Attempts are underway to ascertain the cause for the development and how it can be mitigated.
癌症化疗导致的高血糖/糖尿病（继发性糖尿病）的发生是一个主要问题，而印度此前从未有过相关报道。本研究旨在对接受乳腺癌根治性化疗的女性患者进行此项调查。
这是一项基于病历的回顾性研究，在一家癌症专科医院开展。从病历中收集了治疗开始时非糖尿病女性的信息。考虑了癌症诊断、居住地、体重指数（BMI）、饮食类型、婚姻状况、子女数量以及既往糖尿病史（如有）等细节。记录了手术前和放疗结束后的血糖水平。参考了世界卫生组织（WHO）的糖尿病指南。数据进行了频数和百分比统计，并采用卡方检验进行分析。使用Pearson相关分析探讨人口统计学细节与高血糖、继发性糖尿病或糖尿病前期发生之间的关联。P < 0.05被认为具有统计学意义。
根据纳入标准，共纳入474例病例。结果显示，放疗结束时，24.89%处于糖尿病前期，10.97%在处于糖尿病前期阶段后发展为糖尿病，8.22%未经历糖尿病前期阶段直接发展为糖尿病，55.91%既未发展为糖尿病前期也未发展为糖尿病。继发性糖尿病和糖尿病前期的发生与BMI（P < 0.0001）和年龄（P < 0.024）呈强相关性且具有统计学意义。
据作者所知，这是印度的第一项此类研究，结果表明接受根治性化疗的女性中继发性糖尿病的发生率较高。目前正在努力确定其发生原因以及如何缓解这一情况。
