Terao Naoko, Suzuki Kumi
Graduate School of Nursing Doctoral Program, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Faculty of Nursing, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Asia Pac J Oncol Nurs. 2021 Oct 4;8(6):610-622. doi: 10.4103/apjon.apjon-2131. eCollection 2021 Nov-Dec.
The purpose of this study was to identify the state of self-management in patients with diabetes who underwent chemotherapy, by referring to fluctuations in glycemic excursion and adverse drug reaction. We conducted a literature search in May 2021 using PubMed, CINAHL, and Ichushi-Web databases with "Cancer AND Diabetes AND Chemotherapy" as keywords. Based on our criteria, 25 articles were selected, and a review matrix sheet was created for the analysis of fluctuations in glycemic excursion and any adverse drug reaction to diabetes in patients undergoing chemotherapy. Substantial increases and unpredictable fluctuations in glycemic excursion were observed in these patients. In addition, an increase or change in the treatment dose was prevalent. Primarily, peripheral neuropathy and infection were reported as common adverse drug reactions. The risk of adverse drug reactions was especially high for patients with diabetes undergoing chemotherapy; furthermore, among this cohort, the detrimental effects were more likely to exacerbate into a severe condition that required special attention. Almost inevitably, the implementation rate of diabetes self-management programs decreased on the 8 week after the commencement of chemotherapy. Considering the findings of large individual differences in fluctuation in this cohort, tailored assistance that is appropriate for each patient's chemotherapy regimen or blood glucose level is of paramount importance. Support of patient self-management to achieve stable blood glucose levels and thus prevent adverse drug reactions was a key component in the successful completion of chemotherapy and improved patient outcomes for this group of special needs patients.
本研究的目的是通过参考血糖波动和药物不良反应，确定接受化疗的糖尿病患者的自我管理状况。2021年5月，我们使用PubMed、CINAHL和Ichushi-Web数据库，以“癌症与糖尿病与化疗”为关键词进行了文献检索。根据我们的标准，选择了25篇文章，并创建了一个综述矩阵表，用于分析接受化疗患者的血糖波动和任何糖尿病药物不良反应。在这些患者中观察到血糖波动大幅增加且不可预测。此外，治疗剂量增加或改变很普遍。主要报告的常见药物不良反应是周围神经病变和感染。接受化疗的糖尿病患者发生药物不良反应的风险尤其高；此外，在这一队列中，有害影响更有可能恶化为需要特别关注的严重情况。几乎不可避免的是，化疗开始8周后，糖尿病自我管理项目的实施率下降。考虑到该队列中波动存在巨大个体差异，为每位患者的化疗方案或血糖水平提供量身定制的援助至关重要。支持患者自我管理以实现稳定血糖水平，从而预防药物不良反应，是成功完成化疗并改善这类特殊需求患者预后的关键因素。
