College of Nursing, University of Florida, Gainesville, Florida, USA.
College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.
Cancer Med. 2023 Jun;12(11):12874-12880. doi: 10.1002/cam4.6118. Epub 2023 May 22.
Undiagnosed Type 2 diabetes (T2D) has been associated with advanced stage cancer at diagnosis, higher mortality, and lower long-term all-cause survival. This was a RCT pilot study to examine the feasibility of a nurse-led T2D intervention for adults with newly diagnosed cancer (≤3 months), and T2D, undiagnosed or untreated with medication, conducted at an outpatient oncology clinic affiliated with a large academic institution.
Participants needed to meet the eligibility criteria including a HbA1c level between 6.5% and 9.9%. Randomization was 1:1 to a 3-month intervention that consisted of nursing-led diabetes education and immediate initiation of metformin versus referral to primary care for usual care (control).
Three hundred and seventy nine patients were screened using EHR, 55 agreed to participate, and 3 had eligible HbA1c levels and were randomized in the study. Primary reasons for study exclusion included life expectancy ≤2 years (16.9%), current use or inability to tolerate metformin (14.8%), and abnormal labs that contraindicated metformin use (13.9%).
This study was not feasible due to recruitment inefficiencies, but acceptable to all who qualified.
未确诊的 2 型糖尿病（T2D）与诊断时癌症晚期、更高的死亡率和更低的长期全因生存率相关。这是一项 RCT 试点研究，旨在检验在一家大型学术机构附属的门诊肿瘤诊所为新诊断的癌症（≤3 个月）且伴有 T2D、未经药物诊断或治疗的成年人开展护士主导的 T2D 干预的可行性。
参与者需要符合包括 HbA1c 水平在 6.5%和 9.9%之间的纳入标准。随机分组为 1:1 接受 3 个月的干预，包括护士主导的糖尿病教育和立即开始使用二甲双胍与转介至初级保健进行常规护理（对照组）。
使用电子病历筛选了 379 名患者，有 55 名同意参加，其中 3 名患者的 HbA1c 水平符合纳入标准，并在研究中进行了随机分组。研究排除的主要原因包括预期寿命≤2 年（16.9%）、当前使用或不能耐受二甲双胍（14.8%）以及异常实验室检查提示不能使用二甲双胍（13.9%）。
由于招募效率低下，该研究不可行，但符合所有合格条件的人都可以接受。
