Influence of blood glucose fluctuations on chemotherapy efficacy and safety in type 2 diabetes mellitus patients complicated with lung carcinoma.

Autor:	Fang TZ; Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China., Wu XQ; Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China., Zhao TQ; Department of Endocrine, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China., Wang SS; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China., Fu GM; Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China., Wu QL; Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China., Zhou CW; Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China. nbzhouchengwei@163.com.
Jazyk:	angličtina
Zdroj:	World journal of diabetes [World J Diabetes] 2024 Apr 15; Vol. 15 (4), pp. 645-653.
DOI:	10.4239/wjd.v15.i4.645
Abstrakt:	Background: Patients with type 2 diabetes mellitus (T2DM) have large fluctuations in blood glucose (BG), abnormal metabolic function and low immunity to varying degrees, which increases the risk of malignant tumor diseases and affects the efficacy of tumor chemotherapy. Controlling hyperglycemia may have important therapeutic implications for cancer patients. Aim: To clarify the influence of BG fluctuations on chemotherapy efficacy and safety in T2DM patients complicated with lung carcinoma (LC). Methods: The clinical data of 60 T2DM + LC patients who presented to the First Affiliated Hospital of Ningbo University between January 2019 and January 2021 were retrospectively analyzed. All patients underwent chemotherapy and were grouped as a control group (CG; normal BG fluctuation with a mean fluctuation < 3.9 mmol/L) and an observation group (OG; high BG fluctuation with a mean fluctuation ≥ 3.9 mmol/L) based on their BG fluctuations, with 30 cases each. BG-related indices, tumor markers, serum inflammatory cytokines and adverse reactions were comparatively analyzed. Pearson correlation analysis was performed to analyze the correlation between BG fluctuations and tumor markers. Results: The fasting blood glucose and 2-hour postprandial blood glucose levels in the OG were notably elevated compared with those in the CG, together with markedly higher mean amplitude of glycemic excursions (MAGE), mean of daily differences, largest amplitude of glycemic excursions and standard deviation of blood glucose ( P < 0.05). In addition, the OG exhibited evidently higher levels of carbohydrate antigen 19-9, carbohydrate antigen 125, carcinoembryonic antigen, neuron-specific enolase, cytokeratin 19, tumor necrosis factor-α, interleukin-6, and high-sensitivity C-reactive protein than the CG ( P < 0.05). Pearson analysis revealed a positive association of MAGE with serum tumor markers. The incidence of adverse reactions was significantly higher in the OG than in the CG ( P < 0.05). Conclusion: The greater the BG fluctuation in LC patients after chemotherapy, the more unfavorable the therapeutic effect of chemotherapy; the higher the level of tumor markers and inflammatory cytokines, the more adverse reactions the patient experiences. Competing Interests: 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. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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