Fang TZ, Wu XQ, Zhao TQ, Wang SS, Fu GMZ, Wu QL, Zhou CW. Influence of blood glucose fluctuations on chemotherapy efficacy and safety in type 2 diabetes mellitus patients complicated with lung carcinoma. World J Diabetes 2024; 15(4): 645-653 [PMID: 38680689 DOI: 10.4239/wjd.v15.i4.645]
Corresponding Author of This Article
Cheng-Wei Zhou, MM, Doctor, Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, No. 247 Renmin Road, Jiangbei District, Ningbo 315020, Zhejiang Province, China. nbzhouchengwei@163.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Study
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Fang TZ, Wu XQ, Zhao TQ, Wang SS, Fu GMZ, Wu QL, Zhou CW. Influence of blood glucose fluctuations on chemotherapy efficacy and safety in type 2 diabetes mellitus patients complicated with lung carcinoma. World J Diabetes 2024; 15(4): 645-653 [PMID: 38680689 DOI: 10.4239/wjd.v15.i4.645]
Tian-Zheng Fang, Xian-Qiao Wu, Guo-Mei-Zhi Fu, Qing-Long Wu, Cheng-Wei Zhou, Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China
Ting-Qi Zhao, Department of Endocrine, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China
Shan-Shan Wang, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China
Co-first authors: Tian-Zheng Fang and Xian-Qiao Wu.
Author contributions: Fang TZ and Wu XQ contributed equally to this work and are co-first authors; Fang TZ, Wu XQ and Zhou CW conceived and designed the study; Fang TZ, Wu XQ, Zhao TQ, Wang SS, Fu GMZ, Wu QL and Zhou CW guided the study; Fang TZ, Wu XQ collected the clinical date; Fang TZ, Wu XQ and Zhou CW analyzed the data; and all authors drafted and revised the manuscript.
Supported byChronic Disease Management Center for Thoracic Tumor, The Affiliated Hospital of Medical School of Ningbo University, No. 2021MGZX-07; and Natural Science Foundation of Ningbo, No. 2019A610238.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the First Affiliated Hospital of Ningbo University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Data sharing statement: No additional data are available.
Corresponding author: Cheng-Wei Zhou, MM, Doctor, Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, No. 247 Renmin Road, Jiangbei District, Ningbo 315020, Zhejiang Province, China. nbzhouchengwei@163.com
Received: November 21, 2023 Peer-review started: November 21, 2023 First decision: December 5, 2023 Revised: December 15, 2023 Accepted: February 21, 2024 Article in press: February 21, 2024 Published online: April 15, 2024 Processing time: 142 Days and 16.3 Hours
ARTICLE HIGHLIGHTS
Research background
Lung carcinoma (LC) is the most common malignant tumor in clinical practice that seriously harms human health. Diabetes mellitus (DM) is a common chronic metabolic disorder, with type 2 DM (T2DM) being the most prevalent. The prevalence of DM complicated with LC is increasing worldwide.
Research motivation
Blood glucose (BG) fluctuation is definitely a factor affecting the chemotherapy efficacy and prognosis of patients with DM complicated with cancer. However, whether the BG level can be a predictor of chemotherapy efficacy in LC patients has rarely been studied, and epidemiological evidence is limited.
Research objectives
This study focuses on the influence of BG fluctuations on chemotherapy efficacy in T2DM + LC patients.
Research methods
The clinical data of 60 T2DM + LC patients were retrospectively analyzed. All patients underwent chemotherapy and were grouped as a control group and an observation group based on their BG fluctuations, with 30 cases each. BG-related indices, tumor markers, serum inflammatory cytokines and adverse reactions were comparatively analyzed.
Research results
After chemotherapy, fasting BG and 2-h postprandial BG in the observation group were significantly higher than those in the control group. In addition, the observation group exhibited markedly higher mean amplitude of glycemic excursions, mean of daily differences, largest amplitude of glycemic excursions, and standard deviation of BG than the control group patients with high fluctuating blood glucose ranges have relatively weaker glycemic control and greater blood glucose fluctuations after chemotherapy. The observation group has higher levels of tumor markers and inflammatory indicators than the control group, as well as adverse event rate.
Research conclusions
Large BG fluctuations can enhance the levels of tumor markers and inflammatory factors in T2DM + LC patients and inhibit chemotherapy efficacy, with low safety.
Research perspectives
The control of BG fluctuations occupies an important position in T2DM + LC patients undergoing chemotherapy, which can affect the curative effect of chemotherapy.
