Table 1Summary of Results from Previous Studies Regarding Chemotherapy-Induced Hyperglycemia
Study |
Region |
Study design |
Setting (no. of patients, type of cancer, chemotherapy regimen) |
Diagnostic tool for DM |
Incidence |
Risk factor(s) |
Glucose-lowering therapy |
Outcome |
Previous DM |
New DM |
Feng et al. (2013) [11] |
China |
Retrospective |
362, Colon cancer, 5FU (results incomplete for 44 patients) |
FPG |
FPG, OGTT |
DM: 42 (11.6%)
During treatment: 32
After treatment: 10
IFG: 41(11.3%)
During treatment: 33
After treatment: 8 |
- |
OAD: 22 (52.4%)
LSM: 13 (30.9%)
Observation: 7 (16.7) |
Persistent: 31 (8.6%) |
Lipscombe et al. (2013) [16] |
Canada |
Population-based, retrospective |
Early-stage breast cancer vs. no breast cancer |
History |
2 Claims or 1 hospitalization |
8.9% in patients who underwent adjuvant therapy, 10.0% in patients who did not undergo adjuvant therapy
Age difference |
- |
- |
- |
Ji et al. (2013) [17] |
China |
Retrospective |
119, Breast cancer, chemotherapy |
OGTT |
OGTT |
DM: 21.8%
Prediabetes: 43.7% |
- |
- |
- |
Lee et al. (2014) [18] |
Japan |
Retrospective |
80, Lymphoma, CHOP |
HbA1c |
FPG/random glucose/bA1c |
26 (32.5%) |
Age ≥60 yr
BMI >30 kg/m2
HbA1c >6.1% |
Insulin: 3
LSM: 1 |
Persistent: 2 (2.5%) |
Table 2Recommendations for the Clinical Management of Hyperglycemic Events by Symptom Severity [31]
Grade |
1 |
2 |
3 |
4 |
Glucose level, mg/dL |
ULN-160 |
160–250 |
250–500 |
>500 |
Treatment |
SMBG
No treatment |
SMBG Treat according to standard guidelines |
Everolimus dose adjustment |
None |
None
If intolerable, temporary interruption until recovery to grade 1 or less, then restart at same dose |
Temporary interruption; restart at reduced dose |
Discontinue |