Introduction: Managing people with diabetes and cancer during palliation is a major challenge. The aim of our work was to study the specific characteristics of diabetic people with cancer, to identify management modalities of management during cancer treatment.
Patients and methods: Prospective study including 100 diabetic patients with cancer followed in the different services of Ibn Rochd University Hospital of Casablanca between 2017 and 2018. Variables studied were the characteristics of diabetes and tumors. Statistical analyzes were performed by SPSS version 25.0.
Results: The mean age of our patients was 59 years with a sex ratio of 1.23, an average BMI of 24±5.3 kg/m2, a type 2 diabetes predominating 74%, average seniority of 7.2 years and an average HBA1c of 9.7±2.3%. Parenteral nutrition (12%). During adjunctive therapy diabetes was decompensated in ketosis mode (29%) and hyperglycemic (34%), 39% of patients were initially treated with oral antidiabetic agents requiring the use of intensified insulin therapy. The various cancers found were cerebral (2%), Otorhinolaryngology (7%), Stomatological (2%), Thyroid (2%), Pulmonary (8%), Pancreas (33%), Digestive (5%), Urinary (3%) %), Gynecologic (14%), Bone (2%), Hematologic (22%). 56% had a relapse, disabling pain reported (10%) with opioids, cognitive instability (10%), sleep disorder (15%) and opportunistic infections (43.5%) undergoing antibiotic therapy. The cancer treatment consisted of an iratherapy (2%), hormone therapy (4%), surgery (18%), chemotherapy (26%), combined (40%) and 20% under steroids. Despite patient empowerment and structured interventions, an education on diabetes management and psychological support for the family in 90% and 10% had a poor prognosis.
Conclusion: The therapeutic management of a person with diabetes associated with cancer requires a multidisciplinary involvement, in order to find a balance between therapy and the patients well-being in a disabling chronic disease.
18 - 21 May 2019
European Society of Endocrinology