Getting a diagnosis of cancer or diabetes can be life changing, but it can be especially challenging for those with either disease. Research shows that 8% to 18% of people living with cancer also have diabetes1 and that treating both procedures at the same time complicates the process for nurses and their patients. The American Diabetes Association states, “Cancer and diabetes are more likely to be diagnosed in the same person than would happen to be expected.”
“As our populations age and people live longer, we can expect the number of patients diagnosed with both cancer and diabetes to increase,” said Jill Olausson, PhD, RN, CDE, assistant professor and assistant professor at am Master of Nursing in Healthcare Administration from Azusa Pacific University in California. Olausson is part of the Glycemic Control for Cancer Patients Task Force, a group of nurses committed to improving health-related outcomes and caring for oncology patients with diabetes.
The link between diabetes and cancer
People with diabetes (mainly type 2) are at higher risk of developing certain types of cancer than people without diabetes because the diseases share risk factors such as aging, obesity, poor diet, and physical inactivity.3 Olausson notes that prednisone and other steroids Used to treat or prevent nausea, or as part of cancer treatment, may also cause blood sugar to rise and make the treatment of diabetes worse. Patients receiving steroids should be closely monitored with early glucose tests and additional tests 2 hours after a meal.
Caring for patients with diabetes and cancer
“Patients with cancer with diabetes are at increased risk of developing infections, being hospitalized, and requiring a reduction or interruption of chemotherapy,” said Denise Hershey, PhD, RN, FNPBC, associate professor at Michigan State University’s College of Nursing East Lansing. Unfortunately, according to Hershey, there isn’t enough evidence on how best to treat diabetes in cancer patients. She believes in looking at each patient’s overall health rather than just focusing on their cancer.
“It’s important for oncology nurses to work with diabetes professionals, nutritionists, and others to create a comprehensive care plan for patients,” says Hershey. “Nurses can use a patient’s A1C to assess how well a patient’s diabetes is being controlled [glycated hemoglobin] at the time of their first cancer diagnosis and to see if they appear now [have] Hyperglycemia. “
Care plans can help patients balance their glucose levels with their cancer treatment after they are discharged. “It is important to investigate the barriers patients may face, such as the fact that they cannot afford the high cost of test strips for diabetics,” says Hershey. “Rather than just advising them to exercise, let them know that regular exercise can help stabilize blood sugar levels while reducing the risk of adverse cancer events [AEs] like fatigue and neuropathy. “
Recent research shows that blood sugar over 180 increases the risk of complications in hospital patients.3 According to Hershey, oncology patients sometimes make the mistake of prioritizing their cancer diagnosis over their diabetes.
“We know that blood sugar control plays a role in the overall quality of health of oncology patients and the severity of symptoms, and can also affect overall survival,” says Hershey. “Educating patients about how to manage their glycemic control is just as important as treating their cancer to get the best results.”
Oncology nurses also need to be aware of changes in a patient’s condition. lots
Cancer symptoms are also signs of diabetes. Uncontrolled high blood sugar can lead to dehydration, but extreme thirst can also be an AE of chemotherapy. Both diabetes and cancer complications can cause or worsen neuropathy. “We need to study cancer survival rates and make sure these patients are receiving optimal diabetes care and meeting their glycemic goals,” says Hershey.
