Impact of cancer diagnosis and treatment on glycaemic control among individuals with colorectal cancer using glucose lowering drugs
Zanders,M.M.J. van Herk-Sukel,M.P.P. Herings,R.M.C. van de Poll-Franse,L.V. Haak,H.
Zanders,M.M.J.
van Herk-Sukel,M.P.P.
Herings,R.M.C.
van de Poll-Franse,L.V.
Haak,H.
Abstract
Aims This study aims to evaluate the impact of cancer and its treatment on HbA1c values among individuals with colorectal cancer (CRC) using glucose-lowering drugs (GLDs). Methods Patients with primary CRC (1998–2011) were selected from the Eindhoven Cancer Registry and linked to the PHARMO Database Network including outpatient pharmacy and clinical laboratory data. Patients with more than 2 years of GLDs use prior to cancer diagnosis were included. Linear mixed-effects models were conducted to evaluate changes in HbA1c for colon cancer (CC) and rectal cancer (RC) patients in the 4 years around CRC diagnosis. Results Of all CRC patients (n = 4714), 294 (6 %) GLDs users with CC and 144 (3 %) with RC were selected. In the crude model, mean HbA1c at cancer diagnosis was 6.9 % (51.6 mmol/mol) among CC patients and 7.1 % (53.5 mmol/mol) among RC patients. Among CC patients, HbA1c decreased with 0.12 % per year (p = 0.0002) before cancer diagnosis in the adjusted model, and after diagnosis, it increased with 0.12 % per year (p = 0.02). In subgroup analyses, effects on HbA1c were more pronounced in users of anti-anaemic preparations. Among RC patients, HbA1c decreased before diagnosis with 0.18 % per year (p = 0.0006), whereas after diagnosis it changed non-significantly. Conclusions Among users of GLDs, HbA1c decreased with 0.12–0.18 % (1–2 mmol/mol) per year before CRC diagnosis. Only among CC patients, HbA1c increased after diagnosis (0.12 % per year; 1.3 mmol/mol). Modest changes in HbA1c before CRC diagnosis may reflect the effects of an undiagnosed cancer, such as weight loss, anaemia, or the use of anti-anaemic preparations. Keywords HbA1c, Diabetes mellitus, Colorectal cancer, Glucose-lowering drugs
Description
Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
Research Projects
Organizational Units
Journal Issue
Keywords
SDG 3 - Good Health and Well-being
Citation
Zanders, M M J, van Herk-Sukel, M P P, Herings, R M C, van de Poll-Franse, L V & Haak, H 2016, 'Impact of cancer diagnosis and treatment on glycaemic control among individuals with colorectal cancer using glucose lowering drugs', Acta Diabetologica, vol. 53, no. 5, pp. 727–735. https://doi.org/10.1007/s00592-016-0863-z