Shouman Mohamed, Brabant Michelle, Rehman Noor, Ahmed Shahid, Shahid Rabia K
Saskatchewan Cancer Agency, Regina, SK S4W 0G3, Canada.
Department of Oncology, University of Saskatchewan, Saskatoon, SK S7N 4H4, Canada.
Cancers (Basel). 2024 Aug 11;16(16):2821. doi: 10.3390/cancers16162821.
Both diabetes and cancer are major global health issues that are among the leading causes of morbidity and mortality. There is a high prevalence of diabetes among cancer patients, many of whom require a surgical procedure. This review focuses on the operative complications in patients with diabetes and cancer, and the perioperative management of diabetes in cancer patients.
A literature search of articles in English-published between January 2010 and May 2024-was carried out using the databases PubMed, MEDLINE, Google Scholar, and the Cochrane Database of Systematic Reviews. The search primarily focused on the operative complications in patients with diabetes and cancer, and perioperative management strategies.
The relationship between cancer and diabetes is complex; cancer patients have a high risk of developing diabetes, while diabetes is a risk factor for certain cancers. In addition, various cancer therapies can induce or worsen diabetes in susceptible patients. Many individuals with cancer and diabetes require surgery, and due to underlying diabetes, they may have elevated risks for operative complications. Optimal perioperative management for these patients includes managing perioperative glycemia and other comorbid illnesses, adjusting diabetic and cancer treatments, optimizing nutrition, minimizing the duration of fasting, supporting early mobilization, and providing patient education to enable self-management.
While evidence is limited, optimal perioperative management for patients with both diabetes and cancer is necessary in order to reduce surgical complications. Future studies are needed to develop evidence-informed perioperative strategies and improve outcomes for these patients.
糖尿病和癌症都是全球主要的健康问题，是发病和死亡的主要原因之一。癌症患者中糖尿病的患病率很高，其中许多人需要进行外科手术。本综述重点关注糖尿病合并癌症患者的手术并发症以及癌症患者糖尿病的围手术期管理。
使用PubMed、MEDLINE、谷歌学术和Cochrane系统评价数据库对2010年1月至2024年5月期间发表的英文文章进行文献检索。检索主要集中在糖尿病合并癌症患者的手术并发症和围手术期管理策略。
癌症与糖尿病之间的关系很复杂；癌症患者患糖尿病的风险很高，而糖尿病是某些癌症的危险因素。此外，各种癌症治疗可在易感患者中诱发或加重糖尿病。许多患有癌症和糖尿病的个体需要手术，由于潜在的糖尿病，他们可能有更高的手术并发症风险。这些患者的最佳围手术期管理包括管理围手术期血糖和其他合并症、调整糖尿病和癌症治疗、优化营养、尽量缩短禁食时间、支持早期活动以及提供患者教育以实现自我管理。
虽然证据有限，但为减少手术并发症，对糖尿病合并癌症患者进行最佳围手术期管理是必要的。需要开展进一步研究以制定基于证据的围手术期策略并改善这些患者的预后。
