How to Go About Chemotherapy When One is Diabetic?

By NeNa | Articles

May 31

Many out there are concerned about what they need to do when they’re diagnosed with cancer, yet have diabetes. In other words, what are the risks of undergoing chemotherapy when you have to watch your sugar levels?

It’s understandable why it would be more complicated for a patient like that, so we offer some advice and general information below, all of which is coming from checked sources.

Let’s start with some statistics: Over 25 mil people in the USA alone have been diagnosed with diabetes. And among people who are 65 and older, almost 27% have diabetes. Between 8 and 18% of people who have been diagnosed with cancer have also been diagnosed with diabetes.

This information comes from the Centers for Disease Control and Prevention.

Out of all these, most of them have type 2 diabetes. This type is usually connected with being overweight, old age and family history. Unfortunately, these three can also be reasons for the development of cancer.

This means that those who have already been diagnosed with type 2 diabetes also run the risk of getting diagnosed with cancer, at least more often than those who have not.

In other cases, there have been patients who become aware that they are diabetic only after they have started their cancer treatment.

What’s worth noting is that there is a noticeable connection concerning diabetes and diverse kinds of cancer. Type I diabetes has a higher tendency of occurring with stomach and cervical cancers.

Type II diabetes on the other hand with endometrial, kidney, breast, liver, colon and pancreatic cancers.

Don’t Let Us Keep You in The Dark

And, yes, to answer the question many are asking, being diabetic can certainly complicate your cancer treatments, such as chemotherapy. In fact, it can do so in a number of ways. We shall look at them more closely below.

This goes both ways, as certain kinds of cancer treatment, particularly those newer drugs on the market used for therapy, can encourage diabetes development. This goes especially for those who are prone to developing diabetes in the first place.

But the silver lining in all of this is that there is a huge probability of you reversing this effect.

All in all, one should definitely be careful as both cancer treatment as well as the cancer itself can lead to metabolic changes which, as a consequence, can bring upon or further worsen diabetic symptoms. Diabetes does not fall short as it has the potential to delay cancer treatment.

A Double-Edged Sword

If you have diabetes but are undergoing chemotherapy as well, then there needs to be serious monitoring of your blood sugar levels. Most people who have diabetes have to juggle their medicine with their need for food.

But the problem here is that very often, after chemotherapy, the last thing you want to do is eat. And yet if you are diabetic, the last thing you should do is skip out on meals. This is due to the dangers of a hypoglycemic attack.

So, needless to say, this is quite the tricky situation. This is why it is so important to talk to your doctor or diabetes specialist. The good news is that if you take tablets or are maintaining a healthy diet, than managing your diabetes during chemo shouldn’t be that big of a problem.

However, it is advised that on the days when you’re undergoing chemotherapy, you don’t take any diabetes tablets. Still, as previously mentioned, this is a serious enough issue. In which case, consulting your doctor is the best thing you can do.

Moreover, if the patient happens to be dependent on insulin, it may be suggested that they undergo the first session of chemotherapy in the hospital. That way, the nurses can watch over him or her, and if there is a need to intervene, they can do so quickly.

For example, if the patient needs sugar fast, then it could be provided through a drip instead of orally.

Even though most patients will not need this. But if you still find you are not able to eat your regular diet at home after chemo, then you would most likely need to check your sugar on a more regular basis.

What A Professional Has to Say on the Matter

We have taken it upon ourselves to ask Dr.Farooki, an endocrinologist from Memorial Sloan Kettering, NYC, what he has to say on this subject. He has given us information on what special measures to take when it comes to these kinds of patients.

The Effects of Doing Chemotherapy While Diabetic

Chemotherapy has long been used as one of the main and most common ways to treat cancer patients.

But when those patients also have diabetes, the side effects it brings can present difficulty. This in particular when it comes to keeping the blood sugar levels in check.

Dr. Farooki explains that often to patients undergoing chemo, they also give them steroids to minimize the feeling of nausea. But the problem, in this case, is that steroids can also make your glucose levels go up. And not just by a little either.

It is for this reason that the adjustment of diabetes treatments is a must. Usually, doctors prescribe insulin injections, particularly during the time of taking the steroids.

And for the people who are already at risk of getting diabetes, the steroids can actually aid in its appearing.

Furthermore, for those who already take insulin injections, it can be rather challenging to determine the right dose. Dr. Farooki says one needs to take insulin before a meal. Of course under the circumstance that the patient eats a full meal.

But if a patient has diarrhea or throws up after eating, due to chemotherapy, there is a risk that they do not absorb the food. This, in turn, leads to the danger of their blood sugar sinking too low.

On the other hand, high blood sugar can also cause vomiting which is connected with chemotherapy. So naturally, Dr. Farooki suggests detecting and preventing the high blood sugar levels.

As an added problem, the patients, when not feeling well after chemo, have a much higher chance of craving and reaching out for comfort foods. And since those are usually rather high in carbohydrates, they can have a negative effect on blood sugar as well.

Further Complications That May Arise

Another reason why chemotherapy can fall harder on patients with diabetes, is that they already have their fair share of health issues even before starting chemo.

These specific types of patients can get sicker, since they have less reserves in their systems to battle against the various complications that may arise along the way, such as infections, for example.

Some good news in all this is that there are these new cancer therapies which offer special treatment options for specific patients. And, true enough, these targeted drugs have lesser side effects than the traditional therapy.

But still, some of these do have an effect on the patient’s blood sugar levels.

Dr. Farooki had all of this to say. He was also part of a National Cancer Institute which had taken a deeper look at this topic. They published their recommendations in the Journal of Clinical Oncology back in 2012.

He further explains that, in patients who do not have diabetes, after the treatment with these drugs, their blood sugar levels go back to normal. Sadly, but non-surprisingly, that is not the case with those who do.

The thing is that their diabetes can pose a problem when it comes to beginning treatment with these drugs; at least that’s what the clinical trials so far have shown.

So, What’s The Best Way to Go About It?

Dr. Farooki also had this to say. Patients who are at an advanced stage of cancer, controlling their glycemic levels is not the most important thing to do. For those kinds of patients, what is of crucial and immediate importance is to treat the cancer.

He says that they cannot and should not be deprived of a drug which has the potential to sustain their life, simply because there are concerns revolving around their blood sugar being on the high side.

Now, having said that, it’s not like there should be high blood sugar levels, as they can lead to symptoms such as dehydration, infection, frequent urination, and unwanted weight loss.

It is just that, when comparing it to a worse scenario, in this particular situation, these symptoms are not such a big concern, as there is a bigger one.

Also, since your chemotherapy drugs are known to make you sick, there are some excellent anti-sickness drugs you can obtain that can truly help you. You can also ask your doctor to prescribe you meals in a drink if you find it hard to think about food when you must.

Good nutrition is key, and these calorie-packed drinks give you a much-needed boost.

Some Extra Information

Another piece of advice is to watch out for infections. They may occur more in diabetic cancer patients than the other cancer patients. If you notice any signs of infections, such as higher temperatures, best to contact the cancer center or your doctor at once.

Another thing that’s interesting and hopeful to note is that, according to some research, taking insulin in order to fix hyperglycemia may actually inhibit the advancement of cancer.

Once again, according to Dr. Farooki, both diabetes and cancer are categorized as inflammatory diseases, which revolve around inflammation at a cellular level. So, treating hyperglycemia with insulin may indeed have antiangiogenic and anti-inflammatory plus sides.

But here’s something which might prove the opposite. There have been long debates whether large doses of insulin can actually stimulate the development of cancer.

But let’s not end this on a bad note. There have also been recent studies; there is this oral drug, metformin, which is commonly used in the treatment of diabetes. It turns out that it may actually provide oncologic benefits as well.

Sources: Memorial Sloan Kettering Cancer CenterCancer Research UKCancer Center