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High Glucose Levels In Cancer Patients

How Does Having Diabetes Affect My Cancer Treatment?

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 >>

What Is The Relationship Between Breast Cancer And Diabetes?

What Is The Relationship Between Breast Cancer And Diabetes?

What is the relationship between breast cancer and diabetes? Survivors of breast cancer, who are post-menopausal, have a higher chance of developing diabetes. Scientists are becoming increasingly aware of an association between diabetes and cancer. In this article, we discuss the link. A study, published in Diabetologia, is the largest to observe the link between surviving breast cancer and eventually developing diabetes; it also showed that whether the patient went on to develop diabetes was closely associated with having undergone chemotherapy . The opposite interaction has also been observed: females with diabetes have a 20 percent chance of developing postmenopausal breast cancer. A study from last year demonstrated that people with diabetes over the age of 60 are more likely to develop breast cancer, compared with their counterparts without diabetes. Fast facts on breast cancer and diabetes: It has been observed that having diabetes increases the likelihood of breast cancer, and that having breast cancer increases the likelihood of developing diabetes. Lifestyle changes can help reduce risk long-term. How has the connection between breast cancer and diabetes been established? There has been increased study into the correlation of breast cancer and diabetes. The connection has been made as a result of improvements in diagnosis and treatment of breast cancer. As more women survive breast cancer, it is becoming increasingly important to understand the long-term outcomes for survivors as they grow older. However, few studies have tried to determine what the risk of developing diabetes is for a breast cancer survivor. The study in Diabetalogia is an example of the new research that has established the connection between breast cancer and diabetes more firmly. The team, Continue reading >>

Sugar And Cancer – What You Need To Know

Sugar And Cancer – What You Need To Know

There’s a lot of confusing information and advice out there around sugar. It’s been made the villain of our diet, but where does the consensus lie between how sugar and cancer are linked? Does it cause cancer? Does sugar feed cancer cells, making them grow more aggressively? And how does the sugar we consume through food and drink affect our health, and what can be done about this? In this post we’re taking a long hard look at sugar. We’ll focus specifically on sugar and cancer, busting some myths and covering what researchers are studying in the hopes of finding new ways to treat people with cancer. And we’ll cover why the amount of sugar in our diets is cause for concern. A high-sugar diet can be bad news when it comes to cancer risk, but not for the reasons that often appear in the headlines. But first the basics, what our bodies need sugar for and where it comes from in our diet. Glucose – the fuel of life Search for sugar and cancer on the internet and it doesn’t take long to find alarming warnings that sugar is the “white death” and “cancer’s favourite food”. But this idea that sugar is responsible for kick-starting or fuelling a cancer’s growth is an over-simplification of some complicated biology. Let’s start with what sugar actually is. Sugar comes in many different forms. The simplest form is just as a single molecule, such as glucose and fructose. These molecules of simple sugars can also stick together, either in pairs or as longer chains of molecules. All of these combinations of molecules are carbohydrates, and are our body’s main source of energy. The form of sugar most of us will be familiar with is table sugar, which is a simple sugar that dissolves in water and gives things a sweet taste. Its proper name is sucrose, and it Continue reading >>

Diabetes Management In Cancer Patients

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 >>

Diabetes And Cancer

Diabetes And Cancer

Tweet Studies have shown that diabetes carries an increased risk for a number of different forms of cancer. Having cancer with diabetes can make achieving good diabetes control much more difficult but this can be relieved to some extent. How is type 2 diabetes linked with cancer? One theory for why a link may exist is that high levels of circulating insulin (known as hyperinsulinemia) can promote the growth of tumours. In type 2 diabetes, insulin resistance commonly causes the body to produce more insulin than normal. Another reason why a link may be present is where a harmful lifestyle may lead to obesity and therefore higher risks of both type 2 diabetes and cancer. Cancer and type 2 diabetes The risks of contracting the following cancers are shown to be doubled by the presence of type 2 diabetes: Pancreatic cancer Endometrial cancer (also known as womb cancer) A smaller increased risk, of 20% to 50% is seen for the following forms of cancer. Colorectal cancer Bladder cancer Blood cancers (non-Hodgkin’s lymphoma) The one positive is that incidences of prostate cancer are actually lower for people with type 2 diabetes. Cancer and type 1 diabetes Links between type 1 diabetes and cancer are not so well recorded but it appears there is also an increase in risk of cancers for people with type 1 diabetes. The cancers with the highest increase in risk tended to be different to those noted in type 2 diabetes. The cancers with increased risk in type 1 diabetes include: Stomach cancer Cervical cancer What are the symptoms of cancer? The symptoms of cancer vary widely depending on which part of the body the cancer strikes. What treatment options are open for cancer? The main treatment options for cancer are surgery to remove the cancers or radiotherapy (also known as radiatio Continue reading >>

High Glucose Levels Boost The Aggressiveness Of Highly Metastatic Cholangiocarcinoma Cells Via O-glcnacylation

High Glucose Levels Boost The Aggressiveness Of Highly Metastatic Cholangiocarcinoma Cells Via O-glcnacylation

Increased glucose utilization is a feature of cancer cells to support cell survival, proliferation, and metastasis. An association between diabetes mellitus and cancer progression was previously demonstrated in cancers including cholangiocarcinoma (CCA). This study was aimed to determine the effects of high glucose on protein O-GlcNAcylation and metastatic potentials of CCA cells. Two pairs each of the parental low metastatic and highly metastatic CCA sublines were cultured in normal (5.6 mM) or high (25 mM) glucose media. The migration and invasion abilities were determined and underlying mechanisms were explored. Results revealed that high glucose promoted migration and invasion of CCA cells that were more pronounced in the highly metastatic sublines. Concomitantly, high glucose increased global O-GlcNAcylated proteins, the expressions of vimentin, hexokinase, glucosamine-fructose-6-phosphate amidotransferase (GFAT) and O-GlcNAc transferase of CCA cells. The glucose level that promoted migration/invasion was shown to be potentiated by the induction of GFAT, O-GlcNAcylation and an increase of O-GlcNAcylated vimentin and vimentin expression. Treatment with a GFAT inhibitor reduced global O-GlcNAcylated proteins, vimentin expression, and alleviated cell migration. Altogether, these results suggested the role of high glucose enhanced CCA metastasis via modulation of O-GlcNAcylation, through the expressions of GFAT and vimentin. Cancer cells require high glucose uptake for energy and metabolic intermediate production to support cell survival, growth and metastasis. As a consequence, a high glucose condition has been shown to promote progression in many cancer cells1, e.g., colon, breast, prostate, and bladder2,3,4. Many preclinical studies have indicated positive correlati Continue reading >>

Diabetes And Pancreatic Cancer

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 >>

Hyperglycemia, A Neglected Factor During Cancer Progression

Hyperglycemia, A Neglected Factor During Cancer Progression

Copyright © 2014 Wanxing Duan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Recent evidence from large cohort studies suggests that there exists a higher cancer incidence in people with type 2 diabetes (DM2). However, to date, the potential reasons for this association remain unclear. Hyperglycemia, the most important feature of diabetes, may be responsible for the excess glucose supply for these glucose-hungry cells, and it contributes to apoptosis resistance, oncogenesis, and tumor cell resistance to chemotherapy. Considering associations between diabetes and malignancies, the effect of hyperglycemia on cancer progression in cancer patients with abnormal blood glucose should not be neglected. In this paper, we describe the role that hyperglycemia plays in cancer progression and treatment and illustrate that hyperglycemia may contribute to a more malignant phenotype of cancer cells and lead to drug resistance. Therefore, controlling hyperglycemia may have important therapeutic implications in cancer patients. 1. Introduction Hyperglycemia, or high blood glucose, is a condition in which an excessive amount of glucose circulates in the blood which develops when the body has too little insulin or when the body cannot use insulin properly. A number of medical conditions can cause hyperglycemia, including diabetes mellitus (DM) [1], obesity [2], pancreatitis [3], chronic stress [4], and cancer. Interestingly, the existing epidemiological evidence indicated that all of these hyperglycemia-related conditions are likely to be associated with tumorigenesis or tumor progression [5–7]. Nowadays, Continue reading >>

Acute Hyperglycemia Associated With Anti-cancer Medication

Acute Hyperglycemia Associated With Anti-cancer Medication

Acute Hyperglycemia Associated with Anti-Cancer Medication Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, Goyang, Korea. Corresponding author: Eun Kyung Lee. Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea. Tel: +82-31-920-1743, Fax: +82-31-920-2798, [email protected] Received 2017 Jan 16; Revised 2017 Feb 1; Accepted 2017 Feb 16. Copyright 2017 Korean Endocrine Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Hyperglycemia during chemotherapy occurs in approximately 10% to 30% of patients. Glucocorticoids and L-asparaginase are well known to cause acute hyperglycemia during chemotherapy. Long-term hyperglycemia is also frequently observed, especially in patients with hematologic malignancies treated with L-asparaginase-based regimens and total body irradiation. Glucocorticoid-induced hyperglycemia often develops because of increased insulin resistance, diminished insulin secretion, and exaggerated hepatic glucose output. Screening strategies for this condition include random glucose testing, hemoglobin A1c testing, oral glucose loading, and fasting plasma glucose screens. The management of hyperglycemia starts with insulin or sulfonylurea, depending on the type, dose, and delivery of the glucocorticoid formulation. Mammalian target of rapamycin (mTOR) inhibitors are associated with a high incidence of hyperglycemia, ranging from 13% to 50%. Immunotherapy, such as anti-programmed death 1 (PD-1) antibody treatment, induces hyperglycem Continue reading >>

Liver Cancer Cells Stop Making Glucose As They Become Cancerous

Liver Cancer Cells Stop Making Glucose As They Become Cancerous

Cancer Care & Treatment Learn about prevention, detection, diagnosis, treatment and more by your cancer type. Nursing at the OSUCCC James Meet our oncology nurses and learn about our coveted Magnet designation. Find a Clinical Trial Learn more about clinical trials at the OSUCCC James and how you can participate. Immunotherapy Immunotherapy represents the next frontier of cancer treatment & underscores that no cancer is routine. Precision Cancer Medicine Precision medicine enables cancer specialists to identify and target cancer cells. Genetic Counseling Visit with a genetics expert to determine cancer risk for you and your loved ones. Find a Doctor Search for an OSUCCC James physician & make an appointment with a cancer expert. Liver Cancer Cells Stop Making Glucose As They Become Cancerous Liver cells normally produce glucose to help maintain healthy blood-sugar levels, but they lose that ability when they become cancerous, this study shows. This change might benefit tumor cells by helping them grow and proliferate. The study tracks how this loss happens and suggests that reversing it might offer a new way to treat this often-deadly disease. COLUMBUS, Ohio As liver cancer develops, tumor cells lose the ability to produce and release glucose into the bloodstream, a key function of healthy liver cells for maintaining needed blood-sugar levels. The findings come from a study by scientists at The Ohio State Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC James). The loss of this type of glucose production, a process called gluconeogenesis, is caused by the over-expression of a molecule called microRNA-23a. The change might aid cancer-cell growth and proliferation by helping to maintain high levels of glycolysis Continue reading >>

Sugar And Cancer

Sugar And Cancer

Question: Does sugar feed cancer? Answer: While researchers continue to investigate the connection between sugar and cancer, it remains a source of anxiety-inducing speculation and misinformation in the media and on the internet. Of course, the undeniable answer is that glucose (the form of sugar used most in the body) feeds every cell in the body, and is so important to the function of your brain that the body has several back up strategies to keep blood sugar levels normal. Even without any carbohydrate in the diet, your body will make sugar from other sources, including protein and fat. The idea that sugar could directly fuel the growth of cancer cells can lead some people to avoid all carbohydrate-containing foods. This is counter-productive for anyone struggling to maintain their weight while dealing with side effects of cancer and treatments. More importantly, the inevitable anxiety of trying to completely avoid “all sugar” creates stress. Stress turns on the fight or flight mechanisms, increasing the production of hormones that can raise blood sugar levels and suppress immune function. Both of these things may reduce any possible benefit of eliminating sugar in the first place. Much research shows that it is sugar’s relationship to higher insulin levels and related growth factors that may influence cancer cell growth the most, and increase risk of other chronic diseases. Many types of cancer cells have plenty of insulin receptors, making them respond more than normal cells to insulin’s ability to promote growth. All carbohydrates you eat are broken down to simple sugars in the intestine, where they are absorbed into the blood, increasing blood sugar levels. The pancreas releases insulin in response, which travels throughout the blood stream, and performs Continue reading >>

Hyperglycemia As A Risk Factor For Cancer Progression

Hyperglycemia As A Risk Factor For Cancer Progression

Hyperglycemia as a Risk Factor for Cancer Progression 1Department of Biological Sciences, Ulsan National Institute of Science and Technology School of Life Sciences, Ulsan, Korea. 1Department of Biological Sciences, Ulsan National Institute of Science and Technology School of Life Sciences, Ulsan, Korea. 2Touchstone Diabetes Center, Department of Internal Medicine, Cell Biology and Simmons Cancer, University of Texas Southwestern Medical Center, Dallas, TX, USA. 1Department of Biological Sciences, Ulsan National Institute of Science and Technology School of Life Sciences, Ulsan, Korea. 2Touchstone Diabetes Center, Department of Internal Medicine, Cell Biology and Simmons Cancer, University of Texas Southwestern Medical Center, Dallas, TX, USA. Corresponding author: Jiyoung Park. Department of Biological Sciences, Ulsan National Institute of Science and Technology School of Life Sciences, 50 UNIST-gil, Eonyang-eup, Ulju-gun, Ulsan 689-798, Korea. [email protected] Corresponding author: Philipp E. Scherer. Touchstone Diabetes Center, Department of Internal Medicine, Cell Biology and Simmons Cancer, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-8549, USA, [email protected] Author information Copyright and License information Disclaimer Copyright 2014 Korean Diabetes Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. As the prevalence of diabetes mellitus is substantially increasing worldwide, associated diseases such as renal failure, cardio Continue reading >>

Original Research Serum Glucose And Hemoglobin A1c Levels At Cancer Diagnosis And Disease Outcome

Original Research Serum Glucose And Hemoglobin A1c Levels At Cancer Diagnosis And Disease Outcome

Highlights • Many patients believe that glucose ‘feeds’ cancer and might affect disease outcome. • We evaluated the effect of glycaemic control on survival of cancer patients with DM. • Higher glucose and HbA1C levels were not associated with worse survival. • In patients treated with insulin, higher glucose was associated with better outcome. • These results do not justify tight glycaemic control following cancer diagnosis. Abstract Despite the lack of scientific data, many cancer patients hold the belief that glucose ‘feeds’ cancer and might affect disease outcome. We aimed to evaluate associations between glucose, hemoglobin A1C (HbA1C), and survival among individuals with diabetes and diabetes associated cancers. Five retrospective cohort studies were conducted in a large population-representative database. The study population included all patients with diabetes and an incident diagnosis of colorectal, breast, bladder, pancreatic and prostate cancers. Exposure of interest was serum glucose or HbA1C levels within 6 months prior to cancer diagnosis. Cox regression model was used to calculate hazard-ratio (HR) and 95% confidence-interval (CI) for overall survival. Analyses were adjusted for cancer-specific confounders. A subgroup analysis was performed among insulin-treated patients. Study cohorts included 7916 individuals with incident cancers and concurrent diabetes. There was no association between HbA1C levels and overall survival in colorectal (HR 1.00, 95% CI 0.95–1.06), breast (HR 1.03, 95% CI 0.95–1.11), bladder (HR 0.94, 95% CI 0.86–1.01), pancreatic (HR 0.98, 95% CI 0.94–1.02), or prostate (HR 1.02, 95% CI 0.96–1.08) cancers. Among diabetes patients treated with insulin, there was increased survival with increasing serum glucose, Continue reading >>

Diabetes And Cancer: What's The Connection?

Diabetes And Cancer: What's The Connection?

When Michelle Hall was diagnosed with breast cancer two years ago, she was shocked. "The standing joke in the family was that I came from a long line of stocky French women who lived forever," says Hall, 62, of Salem, N.H. "We had no breast cancer in the family." Hall had been diagnosed with type 2 diabetes in 2001, so she would have special challenges while facing down cancer. As diseases, cancer and diabetes seem a world away from each other. Yet, numerous studies suggest the conditions are linked. People with diabetes are more likely to be diagnosed with cancer than those without diabetes, but why remains unclear. Scientists are still trying to answer even the most basic questions: Does diabetes cause cancer? If so, what kinds of cancer and how? As the interplay between diabetes and cancer becomes clearer, researchers hope to gain an edge against both diseases. The link between diabetes and cancer may be partially explained by risk factors that underlie and raise the risk of both diseases. Sex: Overall, men are more likely to develop both cancer and type 2 diabetes than women. Weight: Overweight and obese people are more likely to develop cancer than lean people. The association between type 2 diabetes and weight is also well established. While it's clear that losing weight reduces the risk for type 2 diabetes, less is known about whether weight loss combats cancer. Diet: Eating patterns that are thought to help prevent and treat type 2 diabeteslimited red and processed meats and abundant vegetables, fruits, and whole grainsare also associated with a lower risk for many types of cancer. Exercise: Studies show that regular physical activity lowers the risk of developing several types of cancer. Likewise, 30 minutes of moderate-intensity exercise per day can reduce th Continue reading >>

Stop Feeding Cancer With Glucose

Stop Feeding Cancer With Glucose

Research shows glucose feeds and even causes cancer cells - can you do something about this? Be Clear: 1. Scientists have actually shownin theJournal of Clinical Investigation January 2014sugar can cause cancer via not one, but two biochemical pathways ( Research in Cancer Watch ). Be Clear:2. There are more than six research studies in the last few years which show that 1.People with the highest levels of blood glucose develop more cancers; 2.People withcancer, who also have the highest blood levels of glucose, survive least. Be Clear: 3.Johns Hopkins scientists have shown starving patients of sugar is crucial in colorectal cancer. I could go on - The researchmakes a mockery of NHS booklets that encourage a diet of cheeseburgers, sticky buns, milkshakes and sweet, sugary tea during chemotherapy. (All because the people treating you dont want you to develop cachexia and actually die from the chemotherapy!) No wonder, the latest recommendations for diets for people having chemotherapy from Memorial Sloan-Kettering and MD Anderson in the USA are to eat healthily, and not pile into rubbish foods with empty calories.Just as we have told you for eight years now. Cancer cells need supplies of common glucose to grow The breakdown of glucose to provide energy is called glycolysis. In a healthy cell, glucose is converted in the cellular cytoplasm in a multi-step process to pyruvate, which passes into the mitochondria (or power stations) to be burned in another multi-step process in the presence of oxygen. This process involves electron transfer in the mitochondrial membrane. Healthy cells can use other forms of food like fats, as precursors. Cancer cells cannot. They can only derive energy from glycolysis and fermentation in the cytoplasm.The mitochondria have been knocked out Continue reading >>

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