Diabetes Management In Cancer Patients
Hyperglycemia is a common challenge during cancer treatment and palliation. In addition, many patients with pre-existing type 1 or type 2 diabetes undergoing cancer treatment develop iatrogenic hyperglycemia with unique features. The most common example is steroid-induced hyperglycemia,[1] but several other scenarios are common and clinically important (Table 1). Special considerations are often necessary regarding standard lifestyle recommendations, optimal choice of antidiabetic drug (Table 2), and goals of therapy.[2] In patients with active cancer, the focus of hyperglycemia management shifts from preventing long-term complications toward avoiding acute and subacute outcomes, such as dehydration from polyuria, infection, catabolic weight loss, hyperosmolar nonketotic states (HNK), and diabetic ketoacidosis (DKA; Table 3).[3,4] It should be noted that the truly emergent conditions HNK and DKA are rare. The more common scenario of an asymptomatic severe elevation in blood glucose level (> 400 mg/dL, for example), although requiring a treatment plan with good hydration and close follow-up, does not typically require an emergency room visit or admission. Two representative clinical cases are presented here. Clinical Vignette #1 Corticosteroid-induced hyperglycemia A 53-year-old woman with a history of pre-diabetes and peripheral blood stem cell transplant for acute myelogenous leukemia (AML) presented with asymptomatic elevated random blood glucose levels. After transplant she developed graft-versus-host disease (GVHD) with liver injury, which was treated with 60 mg of prednisone daily, tapered gradually to 20 mg daily at the time of presentation 2 months later. Random serum glucose level was 396 mg/dL. Previously, all serum glucose levels had been less than 160 mg/dL u Continue reading >>
My Life With Cancer & Diabetes
We're sorry, an error occurred. We are unable to collect your feedback at this time. However, your feedback is important to us. Please try again later. This upcoming Sunday is National Cancer Survivors Day , a worldwide observance the first Sunday in June, dedicated to "showing the world that life after a cancer diagnosis can be meaningful and productive." We almost hate to mention it, but there is some question about a possible link between cancer and diabetes and there are many people out there dealing with both. There's no real proof that one causes the other, yet there are a lot of studies linking the two . Results suggest that anywhere from 8 to 18% of people with cancer also have diabetes. One recent study published in Diabetes Care showed that 16 out of every 100 men with diabetes and 17 out of every 100 women with diabetes said they had cancer, compared to just 7 out of 100 men and 10 out of 100 women without diabetes. So maybe there is some connection...? We're not pointing this out to scare anybody, but rather to pay homage to the folks who are dealing with both illnesses. Despite the stats cited, there's hardly any available literature on treating this combination. One of the few things we found was a 2006 Diabetes Spectrum article by Helen Psarakis, a diabetes nurse practitioner at Yale New Haven Hospital. She states that cancer patients who are on glucocorticoids a steroid used in short term, high-dose chemo treatments often suffer with high blood sugar. In fact, patients at risk for diabetes who begin taking glucocorticoids during cancer treatment are often quickly diagnosed with diabetes too. Insulin is recommended to treat steroid-induced blood sugar, as patients "may require two to three times their usual dose(s) of insulin." Woah. Helen points out a f Continue reading >>
How To Balance Diabetes And Cancer Treatment
How to Balance Diabetes and Cancer Treatment Managing your type 2 diabetes during cancer treatment can be challenging but it can be done. Being treated for cancer when you have type 2 diabetes requires working with a multidisciplinary team of caregivers. Type 2 diabetes can raise your risk for several types of cancer, and it can also affect your cancer treatment if you are diagnosed with cancer. The critical issue is to treat the cancer with whatever works best for the patient and not to avoid any treatment just because of the diabetes, says Derek LeRoith, MD , director of research in the division of endocrinology, diabetes and bone disease at the Icahn School of Medicine at Mount Sinai in New York City. It is vital, though, to take the diabetes into consideration as part of the treatment, says Marilou Terpenning, MD , a physician at Santa Monica Hematology-Oncology Consultants in Santa Monica, California. And that means assembling a multidisciplinary team of caregivers that may include an endocrinologist , internist, surgeon, medical oncologist , and radiation therapist, and a dietitian for nutritional education and counseling,Dr. Terpenning says. Treatment for cancer can affect glucose metabolism and affect the need for monitoring blood sugar and adjustment of medications, she says. The cancer treatment team needs to prepare the joint cancer treatment plan and work with the endocrinologist or internist overseeing diabetes management. The good news is that experts can generally predict how certain treatments such as surgery and chemotherapy will affect diabetes management and advise accordingly, Terpenning says. Many people with diabetes have a form of nerve damage known as diabetic peripheral neuropathy. Peripheral neuropathy can cause tingling, burning, pain, or num Continue reading >>
10 Nutrition Tips For Managing Cancer And Diabetes
November is National Diabetes Awareness Month, and of the more than 13 million Americans who have or have had cancer, eight to 18 percent also have diabetes. It’s an eye-opening statistic and a reminder about why it’s important to be proactive about our overall health and well-being during and after cancer treatment. “Because of the huge link between insulin resistance and cancer, it is critically important for people who have diabetes to manage their blood glucose during cancer treatment,” adds Brooke McIntyre, a clinical oncology dietitian and diabetes program coordinator at CTCA in Tulsa. McIntyre recommends the following tips to help manage cancer and diabetes: Never eat a “naked” carbohydrate. Funny statement, but people remember it! Rather than eating only an apple, eat a handful of nuts or one to two tablespoons of nut butter too. This helps decrease the rise in blood sugar and makes you feel more satisfied. Eat fewer carbohydrates. Decreasing carbohydrate intake not only lowers blood sugar, but can also help lower blood pressure. Eat more veggies, fruits and whole grains. Eating cancer-fighting foods high in fiber can help regulate blood sugar. Foods to add to your diet include: Asian pears, raspberries, blackberries, bananas, blueberries, beans, broccoli, spinach, lentils, peas, corn, flax seeds and whole-grain breads or crackers. Exercise regularly. The American Institute for Cancer Research and the American Diabetes Association recommend 30 minutes of physical activity five days a week to lower risk of cancer recurrence. Add healthy fats to your diet. Say “no” to doughnuts and fried chicken and “hello” to healthy fats such as avocado, salmon and walnuts. Good fats contain antioxidants, help you maintain a steady blood sugar level and feel Continue reading >>
How Does Having Diabetes Affect My Cancer Treatment?
More than 25 million people in the United States have been diagnosed with diabetes, according to the Centers for Disease Control and Prevention. Among people 65 and older, nearly 27 percent have diabetes. The vast majority of diabetes cases are type 2 diabetes, which is associated largely with older age and being overweight as well as family history. Older age and obesity also are risk factors for developing cancer, which means that people with type 2 diabetes are diagnosed with cancer more often than those in the general population. Having diabetes can complicate cancer treatment due to a number of factors. At the same time, some treatments for cancer, including certain newer targeted therapy drugs, can spur the development of diabetes, especially in patients who already had a propensity toward developing the disease, although this effect is usually reversible. Azeez Farooki is a Memorial Sloan Kettering endocrinologist who specializes in treating cancer patients who also have diabetes. We spoke with Dr. Farooki about what special considerations are taken into account when treating this group of patients. A Disease of Blood Sugar “Diabetes is a disease in which a person has increased levels of glucose, or sugar, in the blood,” Dr. Farooki explains. “It can occur because the pancreas does not produce enough insulin — the hormone that allows glucose to be absorbed — or because cells do not respond to the insulin that is produced. Cells should normally take in sugar from the blood; if they don’t, then high blood sugar or ‘hyperglycemia’ results.” The majority of people with type 2 diabetes are overweight, which often causes the body to become resistant to the effects of insulin. Type 2 disease may be treated with insulin injections, other hormonal inject Continue reading >>
Diabetes And Chemotherapy
If you have diabetes, your blood sugar may need closer monitoring while you are having treatment. Chemotherapy can make you feel sick or be sick. You might not want to eat and this can be a problem. If you can't eat, your blood sugar could drop too low causing: faintness sweating coma This is called a hypoglycaemic attack. You and your doctor might need to plan chemotherapy a bit more carefully than would be necessary if you weren’t diabetic. Some chemotherapy combinations include steroids and these might upset your sugar balance. It might be a good idea for you and your cancer doctor to talk to your diabetes specialist. Types of diabetes There are 2 different types of diabetes. How you manage it depends on the type you have: type 1 – you need to have regular insulin injections or an insulin pump type 2 – you may be able to control it with either diet or with a combination of diet and tablets. There are some people with type 2 diabetes who also need to have insulin injections Type 1 diabetes If you are dependent on insulin, your doctor may suggest that you have the first course of chemotherapy in hospital so that the nurses can keep an eye on you. Then, if you need sugar quickly, you can have it through a drip rather than by mouth. It's possible for you to have insulin and a sugar solution (dextrose) given together through a drip in hospital. The insulin dose is based on hourly or 2 hourly blood sugar tests. But most people don't need this. If you are unable to eat your normal diet when you are at home, you may find you need to check your blood sugar a bit more often than you usually would. Type 2 diabetes If you control your diabetes with diet or tablets it should be possible to manage it during chemotherapy without too many problems. Discuss the options with you Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Diabetes and Sleep Apnea: How Sleep Affects Blood Glucose and Diabetes
- Diabetes and eye disease: How diabetes affects vision and eye health
Diabetes And Pancreatic Cancer
Approximately 25.8 million people in the United States, approximately 8.3% of the population, have diabetes. It is estimated that 18.8 million have been diagnosed, but unfortunately, 7.0 million people, or over one fourth, are unaware that they have the disease. Diabetes is a disease in which the body does not make or properly use a pancreatic hormone called insulin. Insulin helps the body utilize glucose (sugar) efficiently. Normally, insulin allows glucose to enter cells to be used for energy. In the case of diabetes, either the body does not produce enough insulin or the amount that is produced is not fully effective. Instead of entering cells, the glucose remains in the blood resulting in high blood glucose levels. Diabetes can cause major health problems, such as high-blood pressure, blindness, kidney disease and neuropathy. Long-term high blood glucose levels can lead to cell damage and long-term complications. There are several types of diabetes. Type 1 diabetes results from the bodys inability to produce insulin and accounts for approximately 5% of those diagnosed with the disease. Type 2 diabetes results from the bodys failure to properly use insulin combined with insulin deficiency and accounts for most diagnosed cases of diabetes in the United States. Pre-diabetes occurs when a persons blood glucose levels are higher than normal, but are not high enough to be diagnosed as type 2 diabetes. Approximately 79 million Americans are pre-diabetic. Other types of diabetes result from specific genetic conditions, surgery, medications, infections, pancreatic diseases and other illnesses. How does diabetes relate to pancreatic cancer? Diabetes may be either a risk factor or a symptom of pancreatic cancer. Pancreatic cancer is more likely to occur in people who have lon Continue reading >>
Diabetes And Indigestion While Undergoing Chemotherapy And Radiation Therapy
Diabetes and Indigestion while Undergoing Chemotherapy and Radiation Therapy Diabetes and Indigestion while Undergoing Chemotherapy and Radiation Therapy My 87-year-old Dad was just diagnosed with bladder cancer. He has indigestion every day now, even though he is on a low fat diet. He is also a recovering stroke patient, with hypertension and insulin diabetes. He starts chemotherapy and radiation soon. How will side effects of chemotherapy and radiation therapy affect his diabetes problems? How do I manage the food intake and blood sugar levels? I am afraid that the side effects will keep him from eating and blood sugar levels will drop too low. Ellen Sweeney, RD, registered dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds: Depending on the type of chemotherapy drugs along with the radiation he receives, he could experience several side effects. These side effects may include nausea, loss of appetite, change in the taste of foods, constipation and/or diarrhea. Any side effects that end up affecting the amount he eats can obviously affect his blood sugar levels. If he does not have a loss of appetite and is able to eat normally, then he would continue to treat his diabetes with his current insulin regimen. If his appetite is poor through treatment, then it becomes more important for him to get his calorie and protein needs met for weight and protein store maintenance than to follow a diabetic diet. Diabetic patients' diets are liberalized during cancer treatment and those patients are allowed to eat differently during treatment, especially if their appetite is poor. It becomes more important to maintain weight in order to prevent nutritional compromise during treatment. Typically, physicians will adjust oral blood sugar medication or Continue reading >>
- The Powerful Combination Of Garlic, Apple Cider Vinegar And Honey Can Fight Diabetes, Obesity, Indigestion And Many More!
- Ultraviolet Radiation Suppresses Obesity and Symptoms of Metabolic Syndrome Independently of Vitamin D in Mice Fed a High-Fat Diet
- Food lobby rigs EU sugar laws while obesity and diabetes spiral out of control
What To Eat During Cancer Treatment And Chemotherapy Diet Tips
What to Eat during Cancer Treatment and Chemotherapy Diet Tips Patients with cancer experience a loss of appetite and a change in taste during treatment, especially chemotherapy. Here are some tasty and healthy tips provided by CPAA that can help you cope with treatment better even at higher doses. A balanced diet for a patient must contain carbohydrates (bread, rice), proteins (meat, poultry, dal), fats (oil and butter), vitamins and fiber (fruits and vegetables). A typical daily diet should include 4 servings of cereals (1 bowl of rice/ 2 chapattis/ 1 slice of bread, nachani, jawar or bajra), 3 servings of proteins (2 oz meat/ 1 bowl whole dal), 2 servings of oil, 2 cups of milk and 4 servings of fruits and vegetables (1 bowl of vegetables, half a banana, 1 orange). In general, there are no restrictions to what a patient can eat, but you should aim for a diet high in proteins and calorific value. It is important for those who are having difficulty eating, to have small and frequent meals so that the total intake is not reduced. During cancer treatment, patients experience a loss of appetite and a change in taste. Diet plays an important part in improving the ability of the patient to cope with treatment even at higher doses. Try to coax the patient's palate by changes in diet and including different items. Take advantage of days when there is an improvement in appetite. If the patient themselves are cooking, cook when you can and freeze the food to be eaten later. It has been observed that building a positive ambience, for example by the judicious use of colours, can help improve appetite. A change in scene, even another room in the house can make a difference. Avoid drinking liquids before and during meals unless absolutely necessary and then have milk instead of wa Continue reading >>
- Glycaemic control in people with type 2 diabetes mellitus during and after cancer treatment: A systematic review and meta-analysis
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Cancer, diabetes and heart disease diet: Is THIS the healthiest way to eat your eggs?
top Foods For Cancer Patients
National Cancer Centre Singapore points out the foods cancer patients should eat and what they should avoid. Continued from previous page. Foods to include in your diet as a cancer patient: Experts at the Outpatient Pharmacy, National Cancer Centre Singapore (NCCS), a member of the SingHealth group, advise patients to eat the right foods before, during and after treatment. Vegetables Tomatoes, carrots, peas, pumpkin and turnips for vitamins and fibre Tomatoes, tomato puree and parsley (especially good for prostate cancer patients) Cruciferous vegetables like broccoli, cauliflower and cabbage contain plant chemicals that can convert bad oestrogen into good oestrogen, and hence reduce cancer risk as well as the risk of a relapse Asparagus and Brussel sprouts for their rich antioxidants Bitter gourd for lowering blood sugar levels Green leafy vegetables for calcium and iron Fruits Oranges provide vitamin C Bananas, kiwi, peaches, mangoes, pears and strawberries for vitamins and fibre Avocadoes, guava, apricots, figs, prunes and raisins for energy Proteins Lean meat, fish, poultry, eggs, tauhu and taukwa Dairy products, nuts, dried beans, dhals and chickpeas Fish and soy foods (especially good for prostate cancer patients) Carbohydrates Rice, noodles, chapatti, wholegrain bread and pasta Wholegrain crackers, oats, corn, potatoes, beans and dairy products Honey, consumed in moderation for its anti-bacterial and anti-fungal properties which may help in preventing infections Foods to avoid as a cancer patient Deep fried, grilled, barbequed, baked meats since subjecting animal protein to high heat creates carcinogenic byproducts called heterocyclic amines Excessive intake of salt, sugar, and oily foods Red meat and processed meats such as Continue reading >>
Eating Well With Pancreatic Cancer And Diabetes
By Deborah Gerszberg, RD, CNSC, CDN Clinical Nutritionist, The Pancreas Center Many of those diagnosed with pancreatic cancer already have (or will get) diabetes. Pancreatic cancer often leads to a significant amount of unintentional weight loss; therefore, a typical diabetic diet may not always be appropriate. If blood sugar is well controlled (or even somewhat controlled) one is usually able to follow a more liberal diabetic diet. The higher the degree of weight loss or malnutrition, the more liberalized the diabetic restrictions should be. Difficult to control blood sugar can be managed with oral medications or insulin injections, as prescribed by a physician. In general, consuming added sugars is unhealthy and should be avoided in excess. Whether or not a patient is diabetic, eating nutrient dense foods with plenty of fat and protein during treatment is a wise choice. That being said, there is nothing wrong with enjoying a sweet treat every now and then, especially if you are eating much less than usual and are losing weight. At that point, stopping any further weight loss is the first priority, even if that means more sugar in your diet. Aim for 3 meals per day with around 4 carbohydrate servings at each meal. In between meals, snacks are encouraged and may include up to 1 carbohydrate serving per snack. Examples of healthy, nutrient dense snacks include nuts and nut butters, sliced cheese, cottage cheese, hummus, plain yogurt, slices of turkey, tuna or egg salad. All of these foods are very low in carbohydrates and also provide a good amount of calories from protein and fat. You may include a serving of a nutrient rich carbohydrate such as ½ banana, a small apple, pear, or orange, ½ cup of cut fruit or berries, a slice of bread or small pita, or vegetable slices Continue reading >>
Diet For Cancer Patients: What To Eat During Chemo | Reader's Digest
Loss of appetite is a common side effect of chemotherapy, but instead of forcing yourself to eat three big meals, eat five or six smaller meals throughout the day to stay properly nourished and energized. Adding protein supplements and higher-calorie foods to your diet will help you sustain a healthy weight. However, every diet for cancer patients looks different, so consult your doctor to personalize your meals according to your condition, diagnosis, and needs. Chemo often leaves you with a queasy stomach, but ginger candy and lemon drops work like a charm. Suck on them before eating, or sip on some flat ginger ale or cola during your meal. This will help ease your dizziness and settle your stomach. These are more natural remedies for an upset stomach . Mouth sores can make it painful to eat even the softest of foods. If treatment has left your mouth in pain, try pureed foods that are easy to swallow, such as custards, rice, eggs, porridge, and soups. The blander the better, since salt or spices can make sores even more painful. Avoid sharp or crunchy foods like crackers, chips, and raw vegetables, as well as spicy foods like hot sauces, curry dishes, salsa, and chili peppers, which also irritate sores. Ward off dry mouth before it takes hold by filling your diet with plenty of sweet and tart foods. According to the NCI, drinking liquids like lemonade and orange juice will help you produce more saliva because their tartness stimulates your saliva glands. However, do not eat or drink these foods if your treatment has left you with a sore mouth or throat, as they will make your symptoms worse. These are other fruit juices that are healthier than you thought . Continue reading >>
How To Manage Diabetes And Cancer Treatment
Between 8% and 18% of cancer patients have diabetes, a chronic condition that impacts the ability to regulate blood sugar levels. And, for many patients, diabetes management takes a backseat to cancer treatment. But managing your blood sugar levels can help your overall health. We spoke with Erma Levy, a research dietitian at MD Anderson, about what cancer patients with diabetes should know. Can cancer treatment affect blood sugar levels? Radiation therapy, steroids and some types of chemotherapy may impact your blood sugar levels. And uncontrolled high blood sugar can lead to dehydration, which is a frequent side effect of chemotherapy. Taking extra care to manage your blood sugar levels can help you stay hydrated and feel better during treatment. Uncontrolled blood sugar levels also can have a negative impact on your other organs. Monitoring your blood sugar levels can help keep them healthy and strong during cancer treatment. What can cancer patients with diabetes do to improve their health? If you have Type II diabetes or pre-diabetes (a high risk for developing diabetes), try to manage it through your diet. As your diet allows, focus on a healthy eating plan that’s rich in fruits, vegetables and whole grains and low in fat and calories. You can help keep your blood sugar level in a safe range by ensuring there’s a balance of these foods in your diet throughout the day. If you’re finding that it’s difficult to eat healthy foods, talk to your doctor or schedule an appointment with a dietitian to find ways to get these foods into your diet. If you’re an MD Anderson patient, your doctor or nurse can refer you to an MD Anderson dietitian. If you have energy, exercise when possible. This can help you maintain a healthy weight, which plays a key part in controll Continue reading >>
Cancer, Diabetes And Heart Disease Diet: Is This The Healthiest Way To Eat Your Eggs?
Heart disease, cancer and diabetes risk could be cut by losing weight Risk reduced by avoiding inflammatory foods Eggs are the most nutritious foods you can eat Poached and hard boiled eggs had the fewest calories Heart disease, cancer and diabetes risk could be reduced by maintaining a healthy weight and reducing inflammation - and eating enough eggs in your diet could be the key. Despite being vilified in past decades as a cholesterol and salmonella risk, they are now a go-to brunch option thanks to their range of health benefits. Rob Hobson, Healthspan’s head of nutrition and author of The Detox Kitchen Bible, pointed out that eggs are one of the most nutritious foods you can eat. “As well as being rich in protein, they are one of the only foods to contain vitamin D, and are a source of nearly every vitamin and mineral you need,” he explained. “Additionally, eggs contain the antioxidants choline and beta carotene which both reduce damage caused by free radicals and help to lower inflammation in the body.” If you are watching your weight, poaching and hard boiling are going to contain fewer calories and fat compared to scrambled or fried From poached to hard boiled and scrambled to fried, what form are eggs best consumed in? “They are great served any which way,” explained Hobson. “But if you are watching your weight, poaching and hard boiling are going to contain fewer calories and fat compared to scrambled or fried which are often cooked using oils, butter and cream.” Jeraldine Curran, The Food Nutritionist (thefoodnutritionist.co.uk), also suggested consuming eggs as a frittata. “That way you can cook it thoroughly on a low heat,” she explained. “A low heat is particularly important with scrambled eggs which, if cooked at a high temperature, Continue reading >>
Nutrition For The Person With Cancer During Treatment
Nutrition is an important part of cancer treatment. Eating the right kinds of foods before, during, and after treatment can help you feel better and stay stronger. Chances are, if you are reading this booklet either you or someone you care about is going through cancer treatment. The American Cancer Society has prepared this guide to help you and your loved ones cope with treatment side effects that might affect how well you can eat. Not everyone has nutrition-related side effects, but this guide will help you address them if and when they come up. You don’t have to read straight through all of the information here. You can just read the sections you need and use the information that applies to you. The information in this guide is not meant to replace the advice of a medical professional. If you have any questions or concerns, you should talk to a doctor, nurse, or dietitian about your nutritional needs. A registered dietitian (RD) can be one of your best sources of information about your diet. If you are going to meet with a dietitian, be sure to write down your questions before your meeting so you won’t forget anything. And be sure to ask the dietitian to repeat or explain anything that’s not clear. If you have questions about something in this guide, a dietitian can give you a more detailed explanation. You can find more detailed discussion of nutrition before, during, and after cancer treatment in our book called American Cancer Society Complete Guide to Nutrition for Cancer Survivors: Eating Well, Staying Well During and After Cancer. For more information or to find a registered dietitian, contact the Academy of Nutrition and Dietetics. Continue reading >>
- Glycaemic control in people with type 2 diabetes mellitus during and after cancer treatment: A systematic review and meta-analysis
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Cashews Nutrition: Helps Prevent Cancer, Diabetes & More
